F Montagnani1, L Stolzuoli, L Croci, C Rizzuti, F Arena, A Zanchi, C Cellesi. 1. Clinic and Laboratory of Infectious Diseases, Molecular Biology Department, University of Siena, Ospedale Le Scotte, Piano 0 lotto IV, Viale Bracci 16, Siena, Italy. montagnani2@unisi.it
Abstract
BACKGROUND: The study investigated macrolide resistance in Streptococcus pyogenes in a central Italian area from 2001 to 2006 and the possible correlation between antibiotic consumption and fluctuations of resistance percentages. MATERIALS AND METHODS: Macrolide and lincosamide susceptibility of 1,419 S. pyogenes isolates was tested by Kirby Bauer method. Macrolide consumption was evaluated as defined daily dose/1,000 inhabitants per day (DID), according to the World Health Organization anatomic therapeutic chemical classification. Spearman's correlation coefficient was used to assess the association between resistance and use of (1) all macrolides pooled, (2) once daily, (3) twice daily, and (4) three times daily dosage regimens. RESULTS: : In total, 320 strains (22.6%) were erythromycin-resistant, 11.4% with the M phenotype and 11.2% with the MLS phenotype. There was a significant decrease in erythromycin resistance during the study period-from 28.1% in 2001 to 15.6% in 2006 (p < 0.01). No significant correlation was found between erythromycin resistance and local overall macrolide consumption, neither during the same year nor during the previous year. In contrast, a significant correlation was found between resistance rates and once-daily macrolide use during the preceding 6 months in Siena r = 0.747, p = 0.008). CONCLUSION: The known greater selective effect of long-acting agents could establish a pressure outcome, resulting in a specific local epidemiology during a relatively short time gap.
BACKGROUND: The study investigated macrolide resistance in Streptococcus pyogenes in a central Italian area from 2001 to 2006 and the possible correlation between antibiotic consumption and fluctuations of resistance percentages. MATERIALS AND METHODS:Macrolide and lincosamide susceptibility of 1,419 S. pyogenes isolates was tested by Kirby Bauer method. Macrolide consumption was evaluated as defined daily dose/1,000 inhabitants per day (DID), according to the World Health Organization anatomic therapeutic chemical classification. Spearman's correlation coefficient was used to assess the association between resistance and use of (1) all macrolides pooled, (2) once daily, (3) twice daily, and (4) three times daily dosage regimens. RESULTS: : In total, 320 strains (22.6%) were erythromycin-resistant, 11.4% with the M phenotype and 11.2% with the MLS phenotype. There was a significant decrease in erythromycin resistance during the study period-from 28.1% in 2001 to 15.6% in 2006 (p < 0.01). No significant correlation was found between erythromycin resistance and local overall macrolide consumption, neither during the same year nor during the previous year. In contrast, a significant correlation was found between resistance rates and once-daily macrolide use during the preceding 6 months in Siena r = 0.747, p = 0.008). CONCLUSION: The known greater selective effect of long-acting agents could establish a pressure outcome, resulting in a specific local epidemiology during a relatively short time gap.
Authors: D L Horn; J B Zabriskie; R Austrian; P P Cleary; J J Ferretti; V A Fischetti; E Gotschlich; E L Kaplan; M McCarty; S M Opal; R B Roberts; A Tomasz; Y Wachtfogel Journal: Clin Infect Dis Date: 1998-06 Impact factor: 9.079
Authors: Michael Green; Judith M Martin; Karen A Barbadora; Bernard Beall; Ellen R Wald Journal: Antimicrob Agents Chemother Date: 2004-02 Impact factor: 5.191
Authors: Ina Gajic; Vera Mijac; Lazar Ranin; Edita Grego; Dusan Kekic; Boris Jegorovic; Aleksandra Smitran; Suncica Popovic; Natasa Opavski Journal: Microb Drug Resist Date: 2018-03-20 Impact factor: 3.431
Authors: G Gherardi; D Petrelli; M C Di Luca; F Pimentel de Araujo; P Bernaschi; A Repetto; J Bellesi; L A Vitali Journal: Eur J Clin Microbiol Infect Dis Date: 2015-05-30 Impact factor: 3.267
Authors: Elisa Viciani; Francesca Montagnani; Giacinta Tordini; Antonio Romano; Lorenzo Salerni; Andrea De Luca; Paolo Ruggiero; Andrea G O Manetti Journal: Front Microbiol Date: 2017-02-28 Impact factor: 5.640