title: Rise of Streptococcus pneumoniae isolates containing both erm(B) and mef(E) genes from an adult tertiary care community hospital system.
abstract: The emergence of macrolide- and lincosamide-resistant Streptococcus pneumoniae is a worldwide concern. Of particular interest is the increasing prevalence of erythromycin and clindamycin-resistant isolates containing both erm(B) and mef genes. This study determined the prevalence of erythromycin and clindamycin resistance in 596 clinical S. pneumoniae isolates from 2 adult tertiary care hospitals over a 4-year period (2001-2004). Erythromycin resistance increased from 24% to 34%, but S. pneumoniae isolates resistant to clindamycin as well as to erythromycin increased from 3% in 2001 to 15.5% in 2004 (5-fold increase). Among erythromycin-resistant isolates, those also resistant to clindamycin (MLS(B) phenotype) increased 3-fold (12.8-45%). Of forty-one erythromycin/clindamycin-resistant S. pneumoniae isolates tested, 29 (71%) contained both erm(B) and mef(E) genes. Pulsed-field gel electrophoresis performed on 28 erm(B) + mef(E) positive isolates identified 2 predominant and possibly related clones, which made up 64% of the isolates.
authors.affiliation: Falor Division of Surgical Research, Summa Health System, Akron, OH 44304, USA.
authors.forename: Linda P
authors.initials: LP
authors.lastname: DiPersio
authors.forename: Joseph R
authors.initials: JR
authors.lastname: DiPersio
authors.forename: Jacqueline A
authors.initials: JA
authors.lastname: Beach
authors.forename: Linda A
authors.initials: LA
authors.lastname: DeFine
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001426:Bacterial Proteins / Q000235:genetics*; D002981:Clindamycin / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000188:drug therapy; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D004917:Erythromycin / Q000627:therapeutic use; D006801:Humans; D008565:Membrane Proteins / Q000235:genetics*; D008780:Methyltransferases / Q000235:genetics*; D013296:Streptococcus pneumoniae / Q000187:drug effects / Q000235:genetics* / Q000254:growth & development; D014481:United States
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; C117866:MefA protein, Streptococcus; D008565:Membrane Proteins; D002981:Clindamycin; D004917:Erythromycin; D008780:Methyltransferases; C431709:ErmA protein, Bacteria