Antimicrobial susceptibility pattern of beta-haemolytic group A, C and G streptococci isolated from North India

Abstract

The objective of this study was to determine the antibiotic resistance amongst beta-haemolytic streptococci (BHS) from North India. A total of 155 BHS isolates, comprising group A streptococci (GAS) (102), group C streptococci (GCS) (25) and group G streptococci (GGS) (28), collected from patients with pharyngitis, rheumatic fever, skin disease and invasive disease were analysed for their antimicrobial susceptibility to 20 antibiotics using the Kirby-Bauer disc diffusion method. The MICs of penicillin, tetracycline, clarithromycin, azithromycin and erythromycin were also determined using the HiComb test, following the Clinical and Laboratory Standards Institute guidelines. The results showed that 37.4 % of BHS isolates were susceptible to all antibiotics and 19.4 % were highly resistant to tetracycline; however, only 2.6-5.2 % were resistant to macrolides. The tetracycline resistance (P,0.05) of BHS was found to be statistically significant. GAS isolates from different sources of infection also showed statistically significant antibiotic resistance to azithromycin (P50.029). Multi-drug resistance was found irrespective of streptococcal emm types. No association between GAS emm types and drug resistance was seen. MIC determination showed all isolates to be susceptible to the five antibiotics tested, except for two GAS and one GGS isolates that were resistant to clarithromycin, and one GAS skin isolate that was resistant to tetracycline. This study suggests that the variation in antibiotic resistance amongst BHS isolates from North India is independent of the isolation source and emm type distribution, hence emphasizing the need for a longitudinal surveillance in different regions of India.

Antibiotic Susceptibility Profile of respiratory pathogens obtained at tertiary care hospital from western Nepal

“…All Streptococcus pyogenes isolated in this study were sensitive to Clindamycin and Vancomycin while they were absolutely resistant to Levofloxacin and Erythromycin. Very similar antibiotic sensitivity patterns of Streptococcus pyogenes are reported earlier [21,22]. The majority of Streptococcus pneumoniae were resistant against Co-Trimoxazole, Clindamycin, and Erythromycin.…”

Molecular epidemiology of macrolide resistant Group A streptococci from Puducherry, India

“…Globally the rate of erythromycin resistance in streptococci is 20% -40%, that is also in accordance with reports from India [4,6]. Macrolide resistance in streptococci is mediated by two major mechanisms, which include target site modification, and macrolide efflux pumps.…”

Controlling acute rheumatic fever and rheumatic heart disease in developing countries

“…A meta-analysis of seven CDRs Two Cochrane reviews found no evidence to change the recommendation of penicillin for the treatment of GAS pharyngitis and the prevention of recurrent ARF; however, further studies in low-income, high-risk populations are needed [63 && ,64 && ]. There is still no reported evidence of GAS developing resistance to penicillin [65].…”