High prevalence of erythromycin resistance of Streptococcus pyogenes in Greek children

Syrogiannopoulos, George A.; Grivea, Ioanna N.; Fitoussi, F.; Katopodis, George D.; Bingen, Édouard; Beratis, Nicholas G.

doi:10.1097/00006454-200109000-00008

Cited by 36 publications

(29 citation statements)

References 33 publications

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“…erm(TR) dominated in our material as in Poland, Bulgaria, and Canada (8, 36, 40) but in contrast to reports from Spain, Belgium, Greece, Argentina, and Finland where M type resistance encoded by mef(A/E) predominates (2,7,14,17,35).…”

Section: Erm(b) and Mef(o) Were Exclusively Associated With Tet(m) Wcontrasting

confidence: 79%

“…The prevalence of resistance was low (2.7%), which is comparable to rates in Denmark (3%) and Canada (4.7%), but in contrast to rates in Finland (7.4%), Poland (12%), Germany (14%), Spain (29.7%), and Greece (38%) (2,3,23,27,35,36,40). erm(TR) dominated in our material as in Poland, Bulgaria, and Canada (8, 36, 40) but in contrast to reports from Spain, Belgium, Greece, Argentina, and Finland where M type resistance encoded by mef(A/E) predominates (2,7,14,17,35).…”

Section: Erm(b) and Mef(o) Were Exclusively Associated With Tet(m) Wmentioning

confidence: 68%

See 1 more Smart Citation

Macrolide-Resistant Streptococcus pyogenes in Norway: Population Structure and Resistance Determinants

Littauer

Caugant

Sangvik

et al. 2006

Antimicrob Agents Chemother

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Section: Erm(b) and Mef(o) Were Exclusively Associated With Tet(m) Wcontrasting

confidence: 79%

Section: Erm(b) and Mef(o) Were Exclusively Associated With Tet(m) Wmentioning

confidence: 68%

Macrolide-Resistant Streptococcus pyogenes in Norway: Population Structure and Resistance Determinants

Littauer

Caugant

Sangvik

et al. 2006

Antimicrob Agents Chemother

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“…In Spain, a temporal association with macrolide consumption has been described (11), and the most recent data in 1999 show an average prevalence of erythromycin resistance of 20% (25). This figure is among the highest in Europe, together with rates in Italy (5) and Greece (32). Interestingly, after France, the three Mediterranean countries also lead Europe in terms of macrolide consumption (2,3).…”

mentioning

confidence: 98%

Pharmacoepidemiological Analysis of Provincial Differences between Consumption of Macrolides and Rates of Erythromycin Resistance among Streptococcus pyogenes Isolates in Spain

et al. 2002

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The M phenotype is by far the most common mechanism of erythromycin resistance among Streptococcus pyogenes isolates in Spain. A geographic analysis of the relationship between within-country differences in the prevalence of M-type resistance to erythromycin in S. pyogenes and the level of consumption of 14-and 15-membered macrolides within different provinces was carried out. From 1998 to 1999, a nationwide multicenter surveillance study yielded 2,039 consecutive pharyngeal isolates of S. pyogenes. Data on antibiotic consumption for the same period were gathered from IMS Health, and the corresponding daily defined doses per 1,000 inhabitants per day were calculated according to the Anatomic Therapeutic Classification index. Macrolide use was subdivided into dosages given three times a day (TID), twice a day (BID), or once a day (OD). Spearman nonparametric correlation coefficients (R) were calculated, and variables proving to be significantly associated (P < 0.1) were introduced into a linear regression model. The total consumption of macrolides presented a significant correlation with the prevalence of resistance (R ‫؍‬ 0.527; P ‫؍‬ 0.032). Neither TID nor BID macrolide consumption showed significant correlations. Only OD consumption had a significance below 0.1. These data are consistent with the hypothesis that only the total consumption of macrolides influences the local rates of M-type erythromycin resistance in S. pyogenes, and subgroups of macrolides seem to have an additive rather than a selective effect by contributing to increasing the final amount of macrolides used. Local variations in total consumption were associated only with BID consumption (R ‫؍‬ 0.849; P ‫؍‬ 0.004). The simple linear regression with total macrolide consumption showed a considerable determination coefficient (R 2 ‫؍‬ 0.678; P ‫؍‬ 0.006). The model explains up to 68% of the measured variation and is clearly better as a predictor of the prevalence of resistance than the mere mean is. By solving the regression equation, the resultant value of 2.2 defined doses per 1,000 inhabitants per day fits with the existence of a critical threshold of selective pressure.

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“…3 Podaci sa Klinike za infektivne bolesti Medicinskog fakulteta u Patrasu, Grčka, govore nam da je u 2000. godini u dečijoj populaciji rezistentnost GAS na eritromicin dostizala 38%, te je stoga i razumljiv njihov poziv za stalno praćenje situacije i pažljivu primenu antibiotika. 4 Jedna studija nemačkih autora je ukazala na značaj restriktivne primene eritromicina i ostalih makrolida u lečenju piogenog streptokoka u njihovoj Dečijoj bolnici, tercijarnoj pedijatrijskoj ustanovi. Uporedjujući rezultate njihovih ranijih studija sa studijom koju su sproveli od 2006. do 2009. godine dobili su značajno smanjenje rezistencije na sve makrolide, sa prethodnih 13,6% na 2,6% u novoj studiji.…”

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The resistance level of Streptococcus pyogenes to erythromycin in Kraljevo during 2011

Igov¹,

Igov²,

Banjanac³

2012

PONS

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Cilj. Piogeni streptokok je jedan od najčešćih i najozbiljnijih bakterijskih uzročnika infekcija ždrela kod čoveka. Zahteva antibiotsko lečenje, najčešće preparatima penicilina. U slučaju potrebe za primenom drugih antibiotika (alergije) najviše se koriste makrolidi (eritromicin). Senzitivnost ove bakterije na eritromicin je visoka, ali je rezistencija u porastu. Cilj rada je da utvrdi kolika je rezistencija piogenog streptokoka na terapiju eritromicinom, u Kraljevu, tokom 2011. godine.Metode. Kao izvor podataka korišćena je baza podataka službe za kliničku mikrobiologiju Zavoda za javno zdravlje Kraljevo za 2011.godinu. Podaci su obrađeni metodom deskriptivne statistike, a za obradu je korišćen kompjuterski program.Rezultati. Tokom 2011. godine na teritoriji grada Kraljeva ukupno je pregledano 5040 uzoraka brisa ždrela odraslih osoba. Od toga je u 4885 uzoraka pronađena fiziološka flora (96,9%), 155 uzoraka je sa patološkim nalazom. Kod 46 pacijenata (0,9% od svih pregledanih, 29,7% od onih gde je izolovana neka bakterijska infekcija) je izolovan piogeni streptokok. Kod 40 nalaza sa piogenim streptokokom je ispitivana osetljivost na eritromicin, senzitivnost je postojala u 28 slučajeva, intermedijaran rezultat je dobijen u 6 slučajeva, a rezistencija na eritromicin u 6 slučajeva (15%).Zaključak. Eritromicin je efikasan lek u terapiji infekcija izazvanih β-hemolitičkim streptokokom iz grupe A. Jedan je od prvih izbora u lečenju ovih infekcija kada je neophodno umesto penicilina dati neki drugi antibiotik. Nekontrolisanim davanjem ovog makrolida rezistentnost piogenog streptokoka na njegovo dejstvo se značajno povećava, te je njegova restriktivna i ciljana primena imperativ u budućem lečenju.Ključne reči: Streptococcus pyogenes; testovi mikrobiološke senzitivnosti; postupak sa uzorkom; eritromicin; javno zdravlje. ORIGINALNI RAD / ORIGINAL ARTICLE ABSTRACTObjective. Streptococcus pyogenes is one of the most common and most severe cause of bacterial infections of the throat in humans. It requires antibiotic therapy, usually penicillin preparations. In case of need of using other antibiotics (due to allergies), macrolides (erythromycin) are most commonly used. The sensitivity of these bacteria to erythromycin is high, but the resistance to it is growing. Aim of the study was determination of level of resistance of Streptococcus pyogenes to erythromycin in Kraljevo, during 2011.Methods. The database of the department of clinical microbiology of Public Health Institute in Kraljevo was used as a source of data collected in 2011. Data were analyzed using the method of descriptive statistics, and computer program as tool for this analysis.Results. During 2011, on the territory of the city of Kraljevo 5040 samples of throat swab taken from adults were analyzed. In 4885 samples physiological flora was found (96.9%), and 155 samples were with pathological findings. In 46 patients streptococcus pyogenes was isolated (that is 0.9% of all surveyed, and 29.7% of those where some type of a bacterial infection was isolated). In ...

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High prevalence of erythromycin resistance of Streptococcus pyogenes in Greek children

Abstract: The current high (38%) prevalence of erythromycin-resistant S. pyogenes in Central and Southern Greece requires continuous surveillance and careful antibiotic policy.

Cited by 36 publications

References 33 publications

Macrolide-Resistant Streptococcus pyogenes in Norway: Population Structure and Resistance Determinants

Macrolide-Resistant Streptococcus pyogenes in Norway: Population Structure and Resistance Determinants

Pharmacoepidemiological Analysis of Provincial Differences between Consumption of Macrolides and Rates of Erythromycin Resistance among Streptococcus pyogenes Isolates in Spain

The resistance level of Streptococcus pyogenes to erythromycin in Kraljevo during 2011

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