title: Prevalence of erythromycin and clindamycin resistance among clinical isolates of the Streptococcus anginosus group in Germany.
abstract: Members of the Streptococcus anginosus group (SAG) are frequently involved in pyogenic infections in humans. In the present study, the antimicrobial susceptibility of 141 clinical SAG isolates to six antimicrobial agents was analysed by agar dilution. All isolates were susceptible to penicillin, cefotaxime and vancomycin. However, 12.8 % displayed increased MIC values (0.12 mg l(-1)) for penicillin. Resistance to erythromycin was detected in eight (5.7 %) isolates. Characterization of the erythromycin-resistant isolates with the double-disc diffusion test revealed Macrolide-Lincosamide-Streptogramin(B) and M-type resistance in six and two isolates, respectively. The erythromycin-resistant isolates were further characterized by PCR for the resistance genes ermA, ermB and mefA. Resistance and intermediate resistance to ciprofloxacin were detected in two and six isolates, respectively. Molecular typing by PFGE revealed a high genetic heterogeneity among the SAG isolates and no evidence for a clonal relationship between the erythromycin-resistant isolates. Our data show that resistance to erythromycin, clindamycin and ciprofloxacin has emerged among SAG isolates in Germany. The implications of these findings for susceptibility testing and antimicrobial therapy of SAG infections are discussed.
authors.affiliation: Hygiene Institut, Universität Heidelberg, Heidelberg, Germany.
authors.forename: Nadine
authors.initials: N
authors.lastname: Asmah
authors.affiliation: Institut für Laboratoriumsdiagnostik, Abt. Mikrobiologie, Vivantes Kliniken, Berlin, Germany.
authors.forename: Bettina
authors.initials: B
authors.lastname: Eberspächer
authors.affiliation: Labor Enders und Partner, Medizinisch-diagnostisches Gemeinschaftslabor, Stuttgart, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Regnath
authors.affiliation: Institut für Medizinische Mikrobiologie, Virologie und Hygiene, Universität Rostock, 18057 Rostock, Germany.
authors.forename: Mardjan
authors.initials: M
authors.lastname: Arvand
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000235:genetics; D015373:Bacterial Typing Techniques; D002981:Clindamycin / Q000494:pharmacology*; D016000:Cluster Analysis; D016172:DNA Fingerprinting; D004269:DNA, Bacterial / Q000235:genetics; D024881:Drug Resistance, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D004917:Erythromycin / Q000494:pharmacology*; D005838:Genotype; D005858:Germany; D006801:Humans; D055231:Lincosamides / Q000494:pharmacology; D008780:Methyltransferases / Q000235:genetics; D008826:Microbial Sensitivity Tests / Q000379:methods; D016133:Polymerase Chain Reaction / Q000379:methods; D013290:Streptococcal Infections / Q000382:microbiology; D034366:Streptococcus anginosus / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D025381:Streptogramin B / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D004269:DNA, Bacterial; D055231:Lincosamides; D025381:Streptogramin B; D002981:Clindamycin; D004917:Erythromycin; C111078:ErmTR protein, bacteria; D008780:Methyltransferases