title: Macrolide resistance and erythromycin resistance determinants among Belgian Streptococcus pyogenes and Streptococcus pneumoniae isolates.
abstract: Resistance of streptococci to macrolide antibiotics is caused by target-site modification or drug efflux. The phenotypic expression of target-site modification can be inducible or constitutive. The prevalence of the three phenotypes among Belgian erythromycin-resistant Group A streptococci (GAS) and Streptococcus pneumoniae isolates was surveyed, their MICs for seven antibiotics were determined and the clonality of the isolates was explored. Of the 2014 GAS isolates tested 131(6.5%) were erythromycin resistant (MIC > 1 mg/L): 110 (84.0%) showed the M-resistance phenotype whereas the remaining 21 strains (16.0%) were constitutively resistant. No inducibly resistant strains were detected. Of 100 S. pneumoniae isolates, 33 were erythromycin resistant (MIC > 1 mg/L). In contrast to the GAS isolates, only 9.1% of the 33 erythromycin-resistant S. pneumoniae isolates showed the M-resistance phenotype. The presence of mefA/E and ermB genes in the M-resistant and constitutively and inducibly resistant strains, respectively, was confirmed by PCR analysis. Genomic analysis based on pulsed-field gel electrophoresis (PFGE) using the restriction enzyme SfiI, revealed 54 different PFGE patterns among the 131 erythromycin-resistant GAS isolates, of which an M6 clone represented 16.0% of the strains; all other clones, exhibiting different M-types, represented <7% of the strains. The S. pneumoniae isolates also appeared to be polyclonally based, as determined by arbitrarily primed PCR. The macrolides miocamycin and rovamycin, the lincosamide clindamycin and the ketolide HMR 3647 showed excellent activity against the M-resistant GAS and S. pneumoniae strains.
authors.affiliation: Department of Microbiology, University Hospital Antwerp, Universitaire Instelling Antwerpen, Universiteitsplein 1, B-2610 Wilrijk, Antwerp, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Descheemaeker
authors.forename: S
authors.initials: S
authors.lastname: Chapelle
authors.forename: C
authors.initials: C
authors.lastname: Lammens
authors.forename: M
authors.initials: M
authors.lastname: Hauchecorne
authors.forename: M
authors.initials: M
authors.lastname: Wijdooghe
authors.forename: P
authors.initials: P
authors.lastname: Vandamme
authors.forename: M
authors.initials: M
authors.lastname: Ieven
authors.forename: H
authors.initials: H
authors.lastname: Goossens
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001530:Belgium; D003001:Cloning, Molecular; D004352:Drug Resistance, Microbial; D016521:Electrophoresis, Gel, Pulsed-Field; D004917:Erythromycin / Q000494:pharmacology*; D005838:Genotype; D008826:Microbial Sensitivity Tests; D010641:Phenotype; D011008:Pneumococcal Infections / Q000382:microbiology; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013290:Streptococcal Infections / Q000382:microbiology; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000235:genetics*; D013297:Streptococcus pyogenes / Q000187:drug effects* / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D004917:Erythromycin