title: mef(A) is the predominant macrolide resistance determinant in Streptococcus pneumoniae and Streptococcus pyogenes in Germany.
abstract: In this study, macrolide-resistant Streptococcus pneumoniae and Streptococcus pyogenes isolates from Germany were carefully characterised by susceptibility testing, phenotyping, polymerase chain reaction (PCR) and sequencing of macrolides resistance genes, and multilocus sequence typing (MLST). Of 2045 S. pneumoniae and 352 S. pyogenes isolates, 437 (21.4%) and 29 (8.2%), respectively, were found to be macrolide-resistant. Amongst the S. pneumoniae isolates, the most prevalent resistance marker was mef(A) (57.7%) followed by erm(B) (27.0%) and mef(E) (11.2%). Of note, the dual resistance mechanism mef(E)+erm(B) was found in a relatively high proportion (4.1%) of pneumococcal isolates. Amongst the S. pyogenes isolates, 31.0% carried mef(A), 34.5% erm(B) and 13.8% erm(A). Dissemination of a single clone [mef(A)-positive England(14)-9] has significantly contributed to the emergence of macrolide resistance amongst pneumococci in Germany.
authors.affiliation: National Reference Center for Streptococci and Institute of Medical Microbiology, University Hospital RWTH Aachen, Pauwelsstrasse 30, Aachen, Germany.
authors.forename: Christine
authors.initials: C
authors.lastname: Bley
authors.forename: Mark
authors.initials: M
authors.lastname: van der Linden
authors.forename: Ralf René
authors.initials: RR
authors.lastname: Reinert
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000235:genetics / Q000378:metabolism*; D015373:Bacterial Typing Techniques; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005838:Genotype; D005858:Germany; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018942:Macrolides / Q000494:pharmacology*; D008565:Membrane Proteins / Q000235:genetics / Q000378:metabolism*; D008780:Methyltransferases / Q000235:genetics; D008826:Microbial Sensitivity Tests; D058885:Multilocus Sequence Typing; D013290:Streptococcal Infections / Q000382:microbiology; D013296:Streptococcus pneumoniae / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D013297:Streptococcus pyogenes / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D018942:Macrolides; C117866:MefA protein, Streptococcus; C431304:MefE protein, Streptococcus pneumoniae; D008565:Membrane Proteins; C551474:ermB protein, Streptococcus pyogenes; D008780:Methyltransferases; C431709:ErmA protein, Bacteria