Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
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 2

Temporal changes in the distribution of major pulsed-field gel electrophoresis and emm types among the 3 macrolide-resistant Streptococcus pyogenes phenotypes*

Macrolide-resistant phenotype Pulsed-field gel electrophoresis cluster (emm type) Frequency (n = 506) No. (%) of macrolide-resistant S. pyogenes
1999 (n = 81) 2000 (n = 41) 2001 (n = 73) 2002 (n = 215) 2003 (n = 96)
Constitutive 1 (emm22) 70 45 (56%) 7 (17%)† 9 (12%) 7 (3%) 2 (2%)
4 (emm28) 45 – – 4 (5%) 15 (7%) 26 (27%)
23 (emm11) 28 – – 1 (1%) 6 (3%) 21 (22%)
M 1001 (emm1) 128 7 (9%) 12 (29%) 23 (32%) 80 (37%)‡ 6 (6%)‡
1002 (emm4 ) 28 2 (2.5%) 2 (5%) 7 (10%) 7 (3%) 10 (10%)

*A ≤6-band difference was employed to assign isolates to a clone according to Tenover et al. (8). PFGE clusters up to 100 designate restriction with SmaI and clusters ≥1,000 designate restriction with SfiI.
†Decrease in prevalence of the 1/emm22 clone from 1999 to 2000 was highly significant (p<0.001).
‡Both the increase and decrease in prevalence of the 1001/emm1 clone from 2001 to 2002 and from 2002 to 2003, respectively, were significant (p<0.01).

Main Article

References
  1. Descheemaeker  P, Chapelle  S, Lammens  C, Hauchecorne  M, Wijdooghe  M, Vandamme  P, Macrolide resistance and erythromycin resistance determinants among Belgian Streptococcus pyogenes and Streptococcus pneumoniae isolates. J Antimicrob Chemother. 2000;45:167–73. DOIPubMedGoogle Scholar
  2. Canton  R, Loza  E, Morosini  MI, Baquero  F. Antimicrobial resistance amongst isolates of Streptococcus pyogenes and Staphylococcus aureus in the PROTEKT antimicrobial surveillance programme during 1999–2000. J Antimicrob Chemother. 2002;50(Suppl S1):9–24. DOIPubMedGoogle Scholar
  3. Cornaglia  G, Ligozzi  M, Mazzariol  A, Masala  L, Lo  CG, Orefici  G, Resistance of Streptococcus pyogenes to erythromycin and related antibiotics in Italy. The Italian Surveillance Group for Antimicrobial Resistance. Clin Infect Dis. 1998;27(Suppl 1):S87–92. DOIPubMedGoogle Scholar
  4. Szczypa  K, Sadowy  E, Izdebski  R, Hryniewicz  W. A rapid increase in macrolide resistance in Streptococcus pyogenes isolated in Poland during 1996–2002. J Antimicrob Chemother. 2004;54:828–31. DOIPubMedGoogle Scholar
  5. Iannelli  F, Santagati  M, Docquier  JD, Cassone  M, Oggioni  MR, Rossolini  G, Type M resistance to macrolides in streptococci is not due to the mef(A) gene, but to mat(A) encoding an ATP-dependent efflux pump [Abstract C1-1188]. Presented at the 44th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC); Washington; 2004 Oct 30–Nov 2.
  6. Reinert  RR, Lutticken  R, Sutcliffe  JA, Tait-Kamradt  A, Cil  MY, Schorn  HM, Clonal relatedness of erythromycin-resistant Streptococcus pyogenes isolates in Germany. Antimicrob Agents Chemother. 2004;48:1369–73. DOIPubMedGoogle Scholar
  7. NCCLS. National Committee for Clinical laboratory Standards. Performance standards for antimicrobial susceptibility testing. Twelfth informational supplement, M100-S12. Wayne (PA); The Committee; 2002.
  8. Tenover  FC, Arbeit  RD, Goering  RV, Mickelsen  PA, Murray  BE, Persing  DH, Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol. 1995;33:2233–9.PubMedGoogle Scholar
  9. Sutcliffe  J, Grebe  T, Tait-Kamradt  A, Wondrack  L. Detection of erythromycin-resistant determinants by PCR. Antimicrob Agents Chemother. 1996;40:2562–6.PubMedGoogle Scholar
  10. Malhotra-Kumar  S, Wang  S, Lammens  C, Chapelle  S, Goossens  H. Bacitracin-resistant clone of Streptococcus pyogenes isolated from pharyngitis patients in Belgium. J Clin Microbiol. 2003;41:5282–4. DOIPubMedGoogle Scholar
  11. Malbruny  B, Nagai  K, Coquemont  M, Bozdogan  B, Andrasevic  AT, Hupkova  H, Resistance to macrolides in clinical isolates of Streptococcus pyogenes due to ribosomal mutations. J Antimicrob Chemother. 2002;49:935–9. DOIPubMedGoogle Scholar
  12. Novotny  GW, Jakobsen  L, Andersen  NM, Poehlsgaard  J, Douthwaite  S. Ketolide antimicrobial activity persists after disruption of interactions with domain II of 23S rRNA. Antimicrob Agents Chemother. 2004;48:3677–83. DOIPubMedGoogle Scholar
  13. Garcia-Rey  C, Aguilar  L, Baquero  F, Casal  J, Martin  JE. Pharmacoepidemiological analysis of provincial differences between consumption of macrolides and rates of erythromycin resistance among Streptococcus pyogenes isolates in Spain. J Clin Microbiol. 2002;40:2959–63. DOIPubMedGoogle Scholar
  14. Bergman  M, Huikko  S, Pihlajamaki  M, Laippala  P, Palva  E, Huovinen  P, Effect of macrolide consumption on erythromycin resistance in Streptococcus pyogenes in Finland in 1997–2001. Clin Infect Dis. 2004;38:1251–6. DOIPubMedGoogle Scholar
  15. Granizo  JJ, Aguilar  L, Casal  J, Dal Re  R, Baquero  F. Streptococcus pyogenes resistance to erythromycin in relation to macrolide consumption in Spain (1986–1997). J Antimicrob Chemother. 2000;46:959–64. DOIPubMedGoogle Scholar
  16. Goossens  H, Ferech  M, Vander Stichele  R, Elseviers  M. Outpatient antibiotic use in Europe and association with resistance. Lancet. 2005;365:579–87.PubMedGoogle Scholar
  17. Weber  P, Filipecki  J, Bingen  E, Fitoussi  F, Goldfarb  G, Chauvin  JP, Genetic and phenotypic characterization of macrolide resistance in group A streptococci isolated from adults with pharyngo-tonsillitis in France. J Antimicrob Chemother. 2001;48:291–4. DOIPubMedGoogle Scholar
  18. Kaplan  EL, Wotton  JT, Johnson  DR. Dynamic epidemiology of group A streptococcal serotypes associated with pharyngitis. Lancet. 2001;358:1334–7. DOIPubMedGoogle Scholar
  19. Nielsen  HU, Hammerum  AM, Ekelund  K, Bang  D, Pallesen  LV, Frimodt-Moller  N. Tetracycline and macrolide co-resistance in Streptococcus pyogenes: co-selection as a reason for increase in macrolide-resistant S. pyogenes? Microb Drug Resist. 2004;10:231–8.PubMedGoogle Scholar

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.

Page created: April 24, 2012
Page updated: April 24, 2012
Page reviewed: April 24, 2012
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external