title: Macrolide resistance in Streptococcus pyogenes isolates from throat infections in the region of Aachen, Germany.
abstract: Macrolide-resistance was assessed in 216 consecutive Streptococcus pyogenes isolates from throat infections in the region of Aachen, Germany. Seventeen isolates were resistant to erythromycin: 12 isolates revealed a macrolide (M) phenotype and harbored mefA, and five strains expressed an inducible macrolide-lincosamide-streptogramin B (MLSB) phenotype of which four strains harbored ermA(TR) and one strain contained ermB(AM). Telithromycin (HMR 3647) and quinupristin/dalfopristin remained active particularly against the ermA(TR)-containing S. pyogenes isolates studied. Random amplified polymorphic DNA analysis identified multiple clones among erythromycin-resistant strains, but did not discriminate beyond the emm-type. mefA was present in three isolates either with emm2, emm12, or emm75, and in nine isolates with emm4. All four strains with ermA(TR) contained emm77, and the single strain with ermB(AM) harbored emm1. Despite the relative low rate of macrolide-resistance, these data suggest that at least three different macrolide-resistance determinants are prevalent in Germany and that mefA has spread rapidly into multiple clones of S. pyogenes.
authors.affiliation: Institute of Medical Microbiology, National Reference Center for Streptococci, University Hospital RWTH Aachen, Germany. cbrandt@post.klinikum.rwth-aachen.de
authors.forename: C M
authors.initials: CM
authors.lastname: Brandt
authors.forename: M
authors.initials: M
authors.lastname: Honscha
authors.forename: N D
authors.initials: ND
authors.lastname: Truong
authors.forename: R
authors.initials: R
authors.lastname: Holland
authors.forename: B
authors.initials: B
authors.lastname: Hövener
authors.forename: A
authors.initials: A
authors.lastname: Bryskier
authors.forename: R
authors.initials: R
authors.lastname: Lütticken
authors.forename: R R
authors.initials: RR
authors.lastname: Reinert
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D004351:Drug Resistance; D004917:Erythromycin / Q000494:pharmacology; D005838:Genotype; D005858:Germany / Q000453:epidemiology; D048628:Ketolides; D018942:Macrolides; D008826:Microbial Sensitivity Tests; D010614:Pharynx / Q000382:microbiology*; D010641:Phenotype; D012150:Polymorphism, Restriction Fragment Length; D018085:Regulon / Q000235:genetics; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000382:microbiology*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013290:Streptococcal Infections / Q000453:epidemiology* / Q000382:microbiology*; D013297:Streptococcus pyogenes / Q000187:drug effects* / Q000302:isolation & purification; D025361:Streptogramins / Q000494:pharmacology; D014769:Virginiamycin / Q000031:analogs & derivatives* / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D048628:Ketolides; D018942:Macrolides; D025361:Streptogramins; D014769:Virginiamycin; D004917:Erythromycin; C106791:telithromycin; C113826:dalfopristin