Yonsei Med J.  2007 Oct;48(5):773-778. 10.3349/ymj.2007.48.5.773.

Macrolide Resistance Trends in beta-Hemolytic Streptococci in a Tertiary Korean Hospital

• Uh Y
• Hwang GY
• Jang IH
• Cho HM
• Noh SM
• Kim HY
• Kwon O
• Yoon KJ

• KMID: 1122613
• DOI: http://doi.org/10.3349/ymj.2007.48.5.773

Abstract

PURPOSE: Erythromycin-resistant beta-hemolytic streptococci (BHS) has recently emerged and quickly spread between and within countries throughout the world. In this study, we evaluate the antimicrobial susceptibility patterns and erythromycin resistance mechanisms of BHS during 2003-2004. MATERIALS AND METHODS: The MICs of seven antimicrobials were determined for 204 clinical isolates of BHS from 2003 to 2004. Resistance mechanisms of erythromycin-resistant BHS were studied by the double disk test as well as by polymerase chain reaction (PCR). RESULTS: Compared with our previous study, resistance among Streptococcus pyogenes isolates to a variety of drugs decreased strikingly: from 25.7% to 4.8% in erythromycin; 15.8% to 0% in clindamycin; and 47.1% to 19.0% in tetracycline. The prevalent phenotypes and genotypes of macrolide-lincosamide-streptograminB (MLSB) resistance in Streptococcus pyogenes isolates have been changed from the constitutive MLSB phenotype carrying erm(B) to the M phenotype with mef(A) gene. In contrast with Streptococcus pyogenes, resistance rates to erythromycin (36.7%), clindamycin (43.1%), and tetracycline (95.4%) in Streptococcus agalactiae isolates did not show decreasing trends. Among the Streptococcus dysgalactiae subsp. equisimilis isolates (Lancefield group C, G), resistance rates to erythromycin, clindamycin, tetracycline and chloramphenicol were observed to be 9.4%, 3.1%, 68.8%, and 9.4%, respectively. CONCLUSION: Continual monitoring of antimicrobial resistance among large-colony-forming BHS is needed to provide the medical community with current data regarding the resistance mechanisms that are most common to their local or regional environments.

Keyword

beta-hemolytic streptococci; antibiotic resistance; macrolides; erythromycin; Streptococcus agalactiae; Streptococcus pyogenes

MeSH Terms

Anti-Bacterial Agents/*pharmacology
Drug Resistance, Multiple, Bacterial
Erythromycin/*pharmacology
Genes, Bacterial
Genotype
Hospitals
Humans
Incidence
Korea
Microbial Sensitivity Tests
Streptococcus/*drug effects/genetics/isolation & purification
Streptococcus agalactiae/drug effects/genetics/isolation & purification
Streptococcus pyogenes/drug effects/genetics/isolation & purification