title: Molecular characterisation of macrolide resistance mechanisms of Streptococcus pneumoniae and Streptococcus pyogenes isolated in Germany, 2002-2003.
abstract: In the present study, a real-time PCR protocol was developed for the detection of macrolide resistance determinants and was validated in a nationwide study in Germany covering a total of 236 Streptococcus pyogenes and 241 Streptococcus pneumoniae strains collected from children < or = 16 years of age with community-acquired infections. Macrolide resistance was observed in 19.9% of pneumococcal strains and 14% of S. pyogenes isolates. Of the erythromycin A-resistant S. pyogenes strains, 93.9% showed the efflux type mef(A); 62.5% of the S. pneumoniae strains were mef(A)- and 37.5% erm(B)-positive. The correlation of the results of real-time PCR assay genotyping in the present study compared with those of conventional PCR genotyping and resistance phenotyping was 100%. Macrolide resistance is of growing concern in Germany. This highly sensitive and specific PCR assay to detect macrolide resistance has the potential to provide sufficiently rapid results to improve antibiotic treatment of streptococcal infections.
authors.affiliation: Institute for Medical Microbiology, National Reference Center for Streptococci, University Hospital, Pauwelsstrasse 30, D-52057 Aachen, Germany. reinert@rwth-aachen.de
authors.forename: Ralf René
authors.initials: RR
authors.lastname: Reinert
authors.forename: Carmen
authors.initials: C
authors.lastname: Franken
authors.forename: Mark
authors.initials: M
authors.lastname: van der Linden
authors.forename: Rudolf
authors.initials: R
authors.lastname: Lütticken
authors.forename: Murat
authors.initials: M
authors.lastname: Cil
authors.forename: Adnan
authors.initials: A
authors.lastname: Al-Lahham
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001483:Base Sequence; D017931:DNA Primers; D004352:Drug Resistance, Microbial / Q000235:genetics*; D005838:Genotype; D005858:Germany; D018942:Macrolides / Q000494:pharmacology*; D016133:Polymerase Chain Reaction; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000235:genetics; D013297:Streptococcus pyogenes / Q000187:drug effects* / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D017931:DNA Primers; D018942:Macrolides