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Volume 11, Number 6—June 2005

Dispatch

Macrolide- and Telithromycin-resistant Streptococcus pyogenes, Belgium, 1999–20031

Surbhi Malhotra-Kumar*Comments to Author , Christine Lammens*, Sabine Chapelle*, Monique Wijdooghe*, Jasper Piessens*, Koen Van Herck*, and Herman Goossens*
Author affiliations: *University of Antwerp, Antwerp, Belgium

Main Article

Table 1

Yearly prevalence of Streptococcus pyogenes isolates screened and of macrolide-resistant S. pyogenes distributed by patient age group and isolate phenotype, 1999—2003

1999 2000 2001 2002 2003
Total S. pyogenes screened 598 336 633 1,226 1,073
Isolated from adults (mean age, 34.7 y; SD, 11.1 y; range, 17 to 91 y) 220 (36.7%) 144 (43.1%) 245 (38.7%) 469 (38.2%) 453 (42.0%)
Isolated from children (mean age, 7.2 y; SD, 3.5 y; range, 3 mo to 16.9 y) 357 (59.6%) 172 (51.2%) 367 (58.0%) 675 (55.0%) 552 (51.0%)
Macrolide-resistant S. pyogenes 81 (14%) 41 (12%) 73 (12%) 215* (18%) 96* (9%)
Isolated from adults 23 (4%) 16 (5%) 29 (5%) 82 (7%) 38† (4%)
Isolated from children 56 (9%) 22 (7%) 44 (7%) 126‡ (10%) 50† (5%)
Constitutive phenotype 49/81 (8%) 10/41§ (3%) 28/73 (4%) 68/215 (6%) 54/96 (5%)
M phenotype 32/81 (5%) 29/41 (9%) 39/73 (6%) 141/215 (12%) 38/96§ (4%)
Inducible phenotype 2/41 (1%) 6/73 (1%) 7/215 (1%) 4/96 (0.4%)

*Increase and decrease in macrolide resistance from 2001 to 2002 and from 2002 to 2003, respectively, was significant (p<0.001).
†Prevalence of macrolide-resistant S. pyogenes decreased significantly among both children and adults from 2002 to 2003 (p<0.0001).
‡Prevalence of macrolide-resistant S. pyogenes increased significantly among children from 2001 to 2002 (p = 0.005).
§Decrease in prevalence of cMLS isolates from 1999 to 2000 (p = 0.005) and of M phenotype isolates from 2002 to 2003 (p<0.0001) was significant. Pearson's χ2-test with Bonferonni post-hoc adjustments was used for all multiple comparisons. p<0.05 (2-sided) was significant.

Main Article

1A preliminary account of this work was presented at the 44th Interscience Conference on Antimicrobial Agents and Chemotherapy, October 30–November 2, 2004, Washington DC, USA.

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