Macrolide resistance in Streptococcus pyogenes: prevalence, resistance determinants, and emm types

Athanasios G Michos, Chrysanthi G Bakoula, Maria Braoudaki, Foteini I Koutouzi, Eleftheria S Roma, Anastasia Pangalis, Georgia Nikolopoulou, Elena Kirikou, Vassiliki P Syriopoulou

Research output: Contribution to journalArticlepeer-review

44 Citations (Scopus)

Abstract

To investigate the antimicrobial resistance trends and the distribution of emm types of group A streptococci (GAS), we examined 1160 clinical isolates of GAS collected between 2003 and 2006. Susceptibilities to commonly used antimicrobial agents were determined by Etest, and macrolide resistance genes were detected by polymerase chain reaction (PCR). GAS isolates were typed by polymerase chain reaction PCR and sequencing of emm gene. The rates of resistance to erythromycin (ERY), clindamycin, azithromycin, tetracycline, and chloramphenicol were 14.9%, 1.4%, 14.9%, 18.9%, 0.6%, respectively. None of the isolates exhibited resistance to penicillin, ceftriaxone, linezolid, moxifloxacin, rifampicin, or vancomycin. Macrolide resistance increased from 12.1% in 2003 to 18.8% in 2006 (P = 0.02). Of 173 ERY-resistant GAS isolates, 93 (53.7%) harbored the mefA gene, 70 (40.4%) the ermA, and 10 (5.8%) the ermB. Eighty percent of the observed emm types are covered by the proposed 26-valent GAS vaccine. Among 173 ERY-resistant isolates, the predominant emm types were 12 (19.5%), 77 (17.9%), and 4 (16.8%), and among 770 ERY-susceptible isolates, the predominant types were 1 (18.8%), 12 (17.5%), 28 (13.8%). The observed antimicrobial resistance trends and the distribution of specific emm types have implications in guiding empiric therapy and in developing vaccine strategies to prevent GAS infections.

Original languageEnglish
Pages (from-to)295-299
Number of pages5
JournalDiagnostic Microbiology and Infectious Disease
Volume64
Issue number3
Early online date22 Apr 2009
DOIs
Publication statusPublished - 1 Jul 2009

Keywords

  • Anti-Bacterial Agents/pharmacology
  • Antigens, Bacterial/genetics
  • Bacterial Outer Membrane Proteins/genetics
  • Carrier Proteins/genetics
  • Child
  • Child, Preschool
  • DNA, Bacterial/genetics
  • Drug Resistance, Bacterial
  • Genes, Bacterial
  • Genotype
  • Humans
  • Infant
  • Macrolides/pharmacology
  • Microbial Sensitivity Tests
  • Serotyping
  • Streptococcal Infections/microbiology
  • Streptococcus pyogenes/classification

Fingerprint

Dive into the research topics of 'Macrolide resistance in Streptococcus pyogenes: prevalence, resistance determinants, and emm types'. Together they form a unique fingerprint.

Cite this