title: Phenotypes and genotypes of macrolide-resistant streptococcus pneumoniae.
abstract: BACKGROUND
  Macrolide resistance in Streptococcus pneumoniae (S. pneumoniae) is a worldwide problem.
  
  
  OBJECTIVE
  The aim of this work was to analyze the phenotypes, genotypes, and clonal relatedness among macrolide-resistant S. pneumoniae strains isolated from various clinical specimens in our hospital.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  80 non-duplicate S. pneumoniae strains were analyzed by polymerase chain reaction for both the erm (B) and mef (A) genes.
  
  
  RESULTS
  Macrolide resistance was observed in 22.5% (18 strains) of strains. Two (11.2%) isolates possessed mef (A), eight possessed erm (B) (44.4%) and eight strains (44.4%) were positive for both erm (B) and mef (A) genes. Although BOX-PCR of 18 macrolide-resistant strains revealed 11 band patterns, they clustered as seven clones with a genetic distance >10% to each other. Eight isolates possessed both erm (B) and mef (A) genes and belonged to a single clone (44.44% of all macrolide-resistant strains).
  
  
  CONCLUSIONS
  Increased positivity rates for both resistance genes have also been reported from other hospitals in Turkey, but this is the first study from Turkey showing the clonal dissemination of both resistance genes.
authors.affiliation: Department of Microbiology and Clinical Microbiology, Cerrahpaşa Faculty of Medicine, İstanbul University, İstanbul, Turkey.
authors.forename: Leyla
authors.initials: L
authors.lastname: Sirekbasan
authors.affiliation: Department of Microbiology and Clinical Microbiology, Cerrahpaşa Faculty of Medicine, İstanbul University, İstanbul, Turkey.
authors.forename: Nevriye
authors.initials: N
authors.lastname: Gönüllü
authors.affiliation: Department of Microbiology and Clinical Microbiology, Cerrahpaşa Faculty of Medicine, İstanbul University, İstanbul, Turkey.
authors.forename: Serhat
authors.initials: S
authors.lastname: Sirekbasan
authors.affiliation: Department of Microbiology and Clinical Microbiology, Cerrahpaşa Faculty of Medicine, İstanbul University, İstanbul, Turkey.
authors.forename: Mert
authors.initials: M
authors.lastname: Kuşkucu
authors.affiliation: Department of Microbiology and Clinical Microbiology, Cerrahpaşa Faculty of Medicine, İstanbul University, İstanbul, Turkey.
authors.forename: Kenan
authors.initials: K
authors.lastname: Midilli
keywords: BOX-PCR; Macrolide resistance; Streptococcus pneumoniae; erm (B); mef (A)