BACKGROUND: Erythromycin is considered to be an adequate alternative to penicillin for patients who are allergic to penicillin. Erythromycin-resistant Streptococcus pyogenes strains have been reported in some parts of the world. METHOD: The in vitro activity of erythromycin and other antimicrobial agents was determined in a total of 1310 clinical Streptococcus pyogenes isolates collected in the city of Madrid from January, 1993, through December, 1996. RESULTS: All strains showed susceptibility to penicillin, rifampin, vancomycin and chloramphenicol. Tetracycline resistance was 8.5%. In 36 of the strains (2.7%) MIC was 4 microg/ml for ofloxacin. Clindamycin resistance was observed in only 18 strains (1.4%); this resistance was constitutive in 15 and inducible in 3 strains. Resistance to erythromycin was observed in 14.3% of the strains, showing an increase during the study period (2.0% in 1993 vs. 22.4% in 1996; chi square for linear trend 68.8, P < 0,0001); >90% of them showed the novel resistance phenotype described by Seppälä et al. and 32 of 32 of these strains showed by PCR the 1.4-kb fragment of the mefA gene recently described as the novel macrolide efflux resistance determinant. The erythromycin-resistant strains were isolated more often in pediatric patients (144 of 872) than in adults (44 of 438) (chi square 9.9, P = 0.0016). CONCLUSION: The study emphasizes the need to screen for resistance to macrolides in S. pyogenes and indicates that resistance to erythromycin in S. pyogenes has increased significantly in Madrid.
BACKGROUND:Erythromycin is considered to be an adequate alternative to penicillin for patients who are allergic to penicillin. Erythromycin-resistant Streptococcus pyogenes strains have been reported in some parts of the world. METHOD: The in vitro activity of erythromycin and other antimicrobial agents was determined in a total of 1310 clinical Streptococcus pyogenes isolates collected in the city of Madrid from January, 1993, through December, 1996. RESULTS: All strains showed susceptibility to penicillin, rifampin, vancomycin and chloramphenicol. Tetracycline resistance was 8.5%. In 36 of the strains (2.7%) MIC was 4 microg/ml for ofloxacin. Clindamycin resistance was observed in only 18 strains (1.4%); this resistance was constitutive in 15 and inducible in 3 strains. Resistance to erythromycin was observed in 14.3% of the strains, showing an increase during the study period (2.0% in 1993 vs. 22.4% in 1996; chi square for linear trend 68.8, P < 0,0001); >90% of them showed the novel resistance phenotype described by Seppälä et al. and 32 of 32 of these strains showed by PCR the 1.4-kb fragment of the mefA gene recently described as the novel macrolide efflux resistance determinant. The erythromycin-resistant strains were isolated more often in pediatric patients (144 of 872) than in adults (44 of 438) (chi square 9.9, P = 0.0016). CONCLUSION: The study emphasizes the need to screen for resistance to macrolides in S. pyogenes and indicates that resistance to erythromycin in S. pyogenes has increased significantly in Madrid.
Authors: Kensuke Nagai; Peter C Appelbaum; Todd A Davies; Linda M Kelly; Dianne B Hoellman; Arjana Tambic Andrasevic; Liga Drukalska; Waleria Hryniewicz; Michael R Jacobs; Jana Kolman; Jolanta Miciuleviciene; Marina Pana; Lena Setchanova; Marianne Konkoly Thege; Helena Hupkova; Jan Trupl; Pavla Urbaskova Journal: Antimicrob Agents Chemother Date: 2002-02 Impact factor: 5.191
Authors: K Nagai; T A Davies; L M Ednie; A Bryskier; E Palavecino; M R Jacobs; P C Appelbaum Journal: Antimicrob Agents Chemother Date: 2001-11 Impact factor: 5.191
Authors: Roman S Kozlov; Tatiana M Bogdanovitch; Peter C Appelbaum; Lois Ednie; Leonid S Stratchounski; Michael R Jacobs; Bülent Bozdogan Journal: Antimicrob Agents Chemother Date: 2002-09 Impact factor: 5.191
Authors: M Bassetti; G Manno; A Collidà; A Ferrando; G Gatti; E Ugolotti; M Cruciani; D Bassetti Journal: Emerg Infect Dis Date: 2000 Mar-Apr Impact factor: 6.883