Macrolide resistance mechanisms and expression of phenotypes among Streptococcus pneumoniae circulating in Italy.

In Italy, macrolide-resistant pneumococci have been isolated at a rate increasing from 6% in 1993 to 31.7% in 1998. A collection of 161 erythromycin-resistant Streptococcus pneumoniae recovered between 1993 and 1997 has now been phenotypically and genotypically characterized. Approximately 90% of these microorganisms possessed a constitutive MLS(B) mechanism of resistance. PCR detected ermB and mefE genes in strains showing MLS(B) and M phenotypes, respectively. Using pulsed-field gel electrophoresis of chromosomal DNA, one dominant restriction profile and its variations were detected in 51 S. pneumoniae isolates collected from different locations, indicating the circulation of a clone characterized by the possession of a great ability to spread.