Antimicrobial resistance in beta-haemolytic streptococci in India

Abstract

Background & objectives:The incidence and severity of invasive and non-invasive infections demonstrate variability over time. The emerging resistance of Group A streptococci (GAS) to commonly used antibiotics is of grave concern. This study was conducted to assess the antimicrobial resistance of beta-haemolytic streptococci (βHS) in India and to ascertain the molecular mechanisms of resistance.Methods:All isolates of βHS from the Trauma Centre of All India Institute of Medical Sciences (AIIMS) (north India), and heavily populated area of old Delhi from 2010 to 2014 and Yashoda Hospital, Secunderabad (in south India, 2010-2012) and preserved isolates of βHS at AIIMS (2005-2009) were included. Phenotypic confirmation was done using conventional methods and the Vitek 2. Antibiotic sensitivity testing was done by disc diffusion and E-test. Detection of resistance genes, erm(A), erm(B), mef(A), tet(M) and tet(O), was done by polymerase chain reaction (PCR).Results:A total of 296 isolates of βHS (240 from north and 21 from south India) were included in the study. Of the 296 βHS, 220 (74%) were GAS, 52 (17.5%) were Group G streptococci and 11 (3.7%), 10 (3.3%) and three (1%) were Group B streptococci, Group C streptococci and Group F streptococci, respectively. A total of 102 (46%) and 174 (79%) isolates were resistant to tetracycline and erythromycin, respectively; a lower resistance to ciprofloxacin (21, 9.5%) was observed. A total of 42 (14%) and 30 (10%) isolates, respectively, were positive for tet(M) and erm(B) genes. Only 13 (5%) isolates were positive for mef(A). None of the isolates were positive for erm(A) and tet(O). There was discordance between the results of E-test and PCR for erythromycin and tetracycline.Interpretation & conclusions:A high level of resistance to erythromycin and tetracycline was seen in βHS in India. Discordance between genotypic and phenotypic results was reported. Absence of erm(A) and tet(O) with high prevalence of tet(M) and erm(B) was observed.

Molecular Characteristics of Streptococcus pyogenes Isolated From Chinese Children With Different Diseases

“…GAS causes a wide spectrum of clinical diseases ranging from mild pharyngitis to life-threatening invasive infections ( Carapetis et al, 2005 ; Walker et al, 2014 ). Although antibiotics are effective and widely used for treating GAS infections, antibiotic resistance, especially to macrolides, is increasing in several countries ( Lu et al, 2017 ; Bhardwaj et al, 2018 ). The rise of antibiotic resistance leads to an increase in mortality, which has become a public health issue of global concern ( Wajima et al, 2014 ; Silva-Costa et al, 2015 ).…”

Status of Biofilm Production and Vancomycin Resistance in Enterococcus in the Rural Population of Mathura, India

“…The present study showed that 28% of Enterococcus species were isolated from urine samples. Different studies from different areas too concluded that urine was the most common sample yielding Enterococci, such as the studies by Mathur et al [ 23 ], Karmarkar et al [ 18 ], and Udo et al [ 24 ], who reported rates of 49%, 50%, and 37% respectively. Vancomycin and teicoplanin resistance were detected in 6.7% and 4.87% of the isolates in the current investigation, respectively.…”

Role of penicillin in the management of group A beta-hemolytic streptococcal pharyngitis

“…23 Despite guidelines recommending the use of erythromycin in GABHS pharyngitis, GABHS isolates in Indian patients are found to be resistant to this antibiotic. 10,34 The minimum inhibitory concentrations (MICs) of various antibiotics against GABHS show that penicillin is the most sensitive antibiotic against GABHS (Table 6).…”