title: [Streptococcus pyogenes: penicillin and erythromycin susceptibility in the cities of Neuquen and Cipolletti].
abstract: Penicillin resistance has not yet been detected in Streptococcus pyogenes. However macrolide-resistant streptococci have emerged in several countries. Only low rates of erythromycin-resistant S. pyogenes were reported in Argentina, with the exception of a 11.1% observed in Mendoza. The aim of the present study was to determine the susceptibility to penicillin and to erythromycin of 251 consecutive clinically-significant isolates of S. pyogenes obtained from four centers of Cipolletti and Neuquén during the period April-December 1998. The double disk test with erythromycin and clindamycin disks was employed as a screening method to detect ERY-resistant streptococci and to determine the phenotype of macrolide resistance. Disk diffusion was also employed for determining penicillin susceptibility. Macrolide-resistant isolates were also tested for penicillin, ceftriaxone, erythromycin, clindamycin and azithromycin susceptibility by the agar dilution method. Additionally they were also tested for erythromycin susceptibility by E-test (AB Biodisk, Solna, Sweden). All streptococci studied were susceptible to penicillin and thirty of them (12.0%) were resistant to erythromycin. All these resistant isolates were also resistant to azithromycin but susceptible to ceftriaxone and clindamycin. They showed the phenotype M (probably efflux-mediated mechanism) and the MICs of erythromycin ranged between 8 and 16 micrograms/ml. According to these results we conclude that in spite of universal susceptibility to penicillin in S. pyogenes, macrolide resistance is a matter of concern in Neuquén and Cipolletti. At least in those cities it appears to be necessary to routinely perform macrolide susceptibility tests in beta-hemolytic streptococci.
authors.affiliation: Sección de Bacteriología y Servicio de Infectología, Policlínico Neuquén, Argentina.
authors.forename: S V
authors.initials: SV
authors.lastname: Soriano
authors.forename: S
authors.initials: S
authors.lastname: Brasili
authors.forename: M
authors.initials: M
authors.lastname: Saiz
authors.forename: C
authors.initials: C
authors.lastname: Carranza
authors.forename: P
authors.initials: P
authors.lastname: Vidal
authors.forename: J
authors.initials: J
authors.lastname: Calderón
authors.forename: H A
authors.initials: HA
authors.lastname: Lopardo
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001118:Argentina; D004352:Drug Resistance, Microbial; D004917:Erythromycin / Q000494:pharmacology*; D010403:Penicillin Resistance; D010406:Penicillins / Q000494:pharmacology*; D013297:Streptococcus pyogenes / Q000187:drug effects*
chemical_list: D000900:Anti-Bacterial Agents; D010406:Penicillins; D004917:Erythromycin