Stepwise acquisition of multiple drug resistance by beta-hemolytic streptococci and difference in resistance pattern by type.

We collected 1,353 strains of beta-hemolytic streptococci of groups A, B, C, and G (1,176 strains of which were group A) isolated in 26 institutions throughout Japan in 1972-1974. The strains were grouped and T-typed by our specific group-and T-factor sera, and the minimal inhibitory concentrations of 10 antibiotics were assayed by the standard method. Resistant strains from the above collection were classified according to group, T-type, and drug resistance pattern. Our data on T-types for 1964-1971 and on drug resistance for 1966-1971 were used to interpret the detected long-term variations in T-type and drug resistance. The stepwise acquisition of multiple drug resistance, the difference in resistance pattern between predominant T-types, and the rarity of single-macrolide resistance were demonstrated.