title: Group a streptococcus antibiotic resistance in southern Brazil: a 17-year surveillance study.
abstract: BACKGROUND
  Scarce data are available about the antimicrobial resistance of Group A Streptococcus in South America.
  
  
  METHODS
  This study evaluated the antimicrobial susceptibility profile of 1,112 isolates of Group A Streptococcus during the period from 1993 to 2009 in Curitiba city, Brazil. Macrolide-resistant isolates were characterized by emm typing and pulsed-field gel electrophoresis.
  
  
  RESULTS
  All isolates were susceptible to penicillin, vancomycin, and tigecycline. On the contrary, 18.6% of the isolates were resistant to tetracycline, presenting a minimum inhibitory concentration (MIC)(50)/MIC(90) of 32/64 mg/L. Erythromycin resistance rose from 1.9% before 2000 to 4% after 2000 and was associated with a marked increased of MIC levels. Simultaneously, both the phenotype and genotype of macrolide resistance were modified as the M phenotypes (mef(A) genotype) were replaced by the cMLS(B) phenotypes (erm(B) genotype).
  
  
  CONCLUSIONS
  This polyclonal spreading of cMLS(B) macrolide resistance has not been previously observed in South America and should stimulate further epidemiological surveillance in this part of the world.
authors.affiliation: Divisão de Laboratórios de Epidemiologia e Controle de Doenças, Laboratório Central do Estado do Paraná (LACEN), Curitiba, Paraná, Brazil. noriko-u@sapmed.ac.jp
authors.forename: Rosângela Stadnick Lauth de Almeida
authors.initials: RS
authors.lastname: Torres
authors.forename: Renato Pedro de Almeida
authors.initials: RP
authors.lastname: Torres
authors.forename: Pierre Robert
authors.initials: PR
authors.lastname: Smeesters
authors.forename: Jussara Kasuko
authors.initials: JK
authors.lastname: Palmeiro
authors.forename: Iara José
authors.initials: IJ
authors.lastname: de Messias-Reason
authors.forename: Libera M
authors.initials: LM
authors.lastname: Dalla-Costa
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D015373:Bacterial Typing Techniques; D001826:Body Fluids / Q000382:microbiology*; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial / Q000187:drug effects / Q000235:genetics*; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D005838:Genotype; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D018942:Macrolides / Q000494:pharmacology*; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010641:Phenotype; D011159:Population Surveillance; D012137:Respiratory System / Q000382:microbiology*; D013290:Streptococcal Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology* / Q000635:transmission; D013291:Streptococcus / Q000145:classification / Q000187:drug effects* / Q000235:genetics* / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents; D018942:Macrolides