title: Susceptibility of Group A Streptococcus to Antimicrobial Agents in Northern Israel: A Surveillance Study.
abstract: BACKGROUND
  Resistant pathogens are an increasing threat affecting millions of people globally. More complicated patients are presented with pathogens harboring new resistance mechanisms, while the pipeline of new antimicrobials hardly proposes solutions. In such a scenario, more severely ill patients remain with no adequate treatment to offer. In addition, massive misuse of antimicrobials, including excessive length of treatment or wrong dosage, also contributes to increasing the rate of pathogens resistance to antimicrobials. Isolation of Streptococcus pyogenes (Group A Streptococcus-GAS) is the main indication for antibiotic treatment to patients diagnosed with acute tonsillitis. Hence, GAS resistance to antibiotics requires periodic monitoring.
  
  
  OBJECTIVE
  To assess susceptibility rates of GAS to penicillin, macrolides, clindamycin, and tetracycline in northern Israel and to compare the findings to the high antimicrobial susceptibility of GAS isolates reported in the same region in 2004 and to other geographical areas.
  
  
  METHODS
  Throat samples from 300 outpatients were collected and cultured at the regional laboratory of Emek Medical Center during September to October 2011.
  
  
  RESULTS
  In 300 samples, the susceptibility rates of GAS to penicillin, erythromycin, azithromycin, clindamycin, and tetracycline in northern Israel still remain very high.
  
  
  CONCLUSIONS
  Continuous control of antimicrobials usage and periodic surveillance of susceptibility rates, together with educational programs and appropriate and targeted treatment protocols, are essential and highly recommended to keep these high susceptibility rates for as long as possible.
authors.affiliation: 1 Infectious Diseases Unit, Emek Medical Center , Afula, Israel .|2 Rappaport Faculty of Medicine, Technion , Haifa, Israel .
authors.forename: Bibiana
authors.initials: B
authors.lastname: Chazan
authors.affiliation: 1 Infectious Diseases Unit, Emek Medical Center , Afula, Israel .|2 Rappaport Faculty of Medicine, Technion , Haifa, Israel .
authors.forename: Raul
authors.initials: R
authors.lastname: Raz
authors.affiliation: 1 Infectious Diseases Unit, Emek Medical Center , Afula, Israel .
authors.forename: Hana
authors.initials: H
authors.lastname: Edelstein
authors.affiliation: 3 Microbiology Laboratory, Emek Medical Center , Afula, Israel .
authors.forename: Yoram
authors.initials: Y
authors.lastname: Kennes
authors.affiliation: 3 Microbiology Laboratory, Emek Medical Center , Afula, Israel .
authors.forename: Vered
authors.initials: V
authors.lastname: Gal
authors.affiliation: 2 Rappaport Faculty of Medicine, Technion , Haifa, Israel .|3 Microbiology Laboratory, Emek Medical Center , Afula, Israel .
authors.forename: Raul
authors.initials: R
authors.lastname: Colodner
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D017963:Azithromycin / Q000494:pharmacology; D002648:Child; D002981:Clindamycin / Q000494:pharmacology; D024881:Drug Resistance, Bacterial; D062665:Epidemiological Monitoring; D004917:Erythromycin / Q000494:pharmacology; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D008826:Microbial Sensitivity Tests; D010406:Penicillins / Q000494:pharmacology; D013290:Streptococcal Infections / Q000188:drug therapy* / Q000382:microbiology; D013297:Streptococcus pyogenes / Q000187:drug effects* / Q000254:growth & development / Q000302:isolation & purification; D013752:Tetracycline / Q000494:pharmacology; D014069:Tonsillitis / Q000188:drug therapy* / Q000382:microbiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D010406:Penicillins; D002981:Clindamycin; D004917:Erythromycin; D017963:Azithromycin; D013752:Tetracycline