Macrolide and Clindamycin Resistance in Group a Streptococci Isolated From Children With Pharyngitis

DeMuri, Gregory P.; Sterkel, Alana; Kubica, P; Duster, Megan; Reed, Kurt D.; Wald, Ellen R.

doi:10.1097/inf.0000000000001442

Cited by 46 publications

(31 citation statements)

References 13 publications

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“…However, the resistance rate of macrolides has also been increasing gradually [7]. Of the GAS isolates recovered from the throat swabs of children with pharyngitis in Madison, Wisconsin, 15% demonstrated nonsusceptibility for clindamycin and erythromycin, and inducible resistance (positive D-test) was detected in 12% isolates [24]. S. pyogenes isolates collected from infected patients from 7 cities/provinces in China during the years 2009-2016, were phenotypically susceptible to penicillin, ampicillin, cefotaxime, and vancomycin, whereas 93.5, 94.2, and 86.4% were resistant to erythromycin, clindamycin, and tetracycline, respectively [25].…”

Section: Discussionmentioning

confidence: 99%

Molecular epidemiology and antimicrobial resistance of group a streptococcus recovered from patients in Beijing, China

Zhou

Zhao

et al. 2020

BMC Infect Dis

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Background: Group A streptococcus (GAS) is an important human pathogen responsible for a broad range of infections. Epidemiological surveillance has been crucial to detect changes in the geographical and temporal variation of the disease pattern. The objective of this study was to investigate the molecular epidemiological characteristics and antimicrobial resistance of GAS isolates from patients in Children's Hospital in Beijing. Methods: From 2016 to 2017, pharyngeal swab samples were collected from the outpatients in Children's Hospital, Capital Institute of Pediatrics, who were diagnosed with scarlet fever. Antimicrobial susceptibility test was performed according to the distribution of conventional antibiotics and Clinical and Laboratory Standards Institute (CLSI) recommendations. The distribution of the macrolide-resistance genes (ermB, ermA, mefA), emm (M proteincoding gene) typing, and superantigens (SAg) gene profiling were examined by polymerase chain reaction (PCR). Results: A total of 297 GAS isolates were collected. The susceptibility of the isolates to penicillin, ceftriaxone, and levofloxacin was 100%. The resistance rate to erythromycin and clindamycin was 98.3 and 96.6%, respectively. The dominant emm types were emm12 (65.32%), emm1 (27.61%), emm75 (2.69%), and emm89 (1.35%). Of the 297 isolates, 290 (97.64%) carried the ermB gene, and 5 (1.68%) carried the mefA gene, while none carried the ermA gene. The most common superantigen genes identified from GAS isolates were smeZ (96.97%), speC (92.59%), speG (91.58%), ssa (85.52%), speI (54.55%), speH (52.19%), and speA (34.34%). Isolates with the genotype emm1 possessed speA, speC, speG, speJ, speM, ssa, and smeZ, while emm12 possessed speC, speG, speH, speI, speM, ssa, and smeZ superantigens. Conclusions: The prevalent strain of GAS isolates in Beijing has a high resistance rate to macrolides; however, penicillin can still be the preferred antibiotic for treatment. Erythromycin resistance was predominantly mediated by ermB. The common emm types were emm12 and emm1. There was a correlation between emm and the superantigen gene. Thus, long-term monitoring and investigation of the emm types and superantigen genes of GAS prevalence are imperative.

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Section: Discussionmentioning

confidence: 99%

Molecular epidemiology and antimicrobial resistance of group a streptococcus recovered from patients in Beijing, China

Zhou

Zhao

et al. 2020

BMC Infect Dis

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show abstract

“…Madison, Wisconsin, 15% demonstrated nonsusceptibility for clindamycin and erythromycin, and inducible resistance (positive D-test) was detected in 12% isolates [24]. S. pyogenes isolates collected from infected patients from 7 cities/provinces in China during the years 2009-2016, were phenotypically susceptible to penicillin, ampicillin, cefotaxime, and vancomycin, whereas 93.5%, 94.2%, and 86.4% were resistant to erythromycin, clindamycin, and tetracycline, respectively [25].…”

Section: Antimicrobial Susceptibility Testing Resultsmentioning

confidence: 99%

Molecular epidemiology and antimicrobial resistance of group A streptococcus recovered from patients in Beijing, China

Zhang

Zhao

et al. 2020

Preprint

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Background: Group A streptococcus (GAS) is an important human pathogen responsible for a broad range of infections. Epidemiological surveillance has been crucial to detect changes in the geographical and temporal variation of the disease pattern. The objective of this study was to investigate the molecular epidemiological characteristics and antimicrobial resistance of GAS isolates from patients in Children’s Hospital in Beijing. Methods: From 2016 to 2017, pharyngeal swab samples were collected from the outpatients in Children’s Hospital, Capital Institute of Pediatrics, who were diagnosed with scarlet fever. Antimicrobial susceptibility test was performed according to the distribution of conventional antibiotics and Clinical and Laboratory Standards Institute (CLSI) recommendations. The distribution of the macrolide-resistance genes (ermB, ermA, mefA), emm (M protein-coding gene) typing, and superantigens (SAg) gene profiling were examined by polymerase chain reaction (PCR). Results: A total of 297 GAS isolates were collected. The susceptibility of the isolates to penicillin, ceftriaxone, and levofloxacin was 100%. The resistance rate to erythromycin and clindamycin was 98.3% and 96.6%, respectively. The dominant emm types were emm12 (65.32%), emm1 (27.61%), emm75 (2.69%), and emm89 (1.35%). Of the 297 isolates, 290 (97.64%) carried the ermB gene, and 5 (1.68%) carried the mefA gene, while none carried the ermA gene. The most common superantigen genes identified from GAS isolates were smeZ (96.97%), speC (92.59%), speG (91.58%), ssa (85.52%), speI (54.55%), speH (52.19%), and speA (34.34%). Isolates with the genotype emm1 possessed speA, speC, speG, speJ, speM, ssa, and smeZ, while emm12 possessed speC, speG, speH, speI, speM, ssa, and smeZ superantigens. Conclusions: The prevalent strain of GAS isolates in Beijing has a high resistance rate to macrolides; however, penicillin can still be the preferred antibiotic for treatment. Erythromycin resistance was predominantly mediated by ermB. The common emm types were emm12 and emm1. There was a correlation between emm and the superantigen gene. Thus, long-term monitoring and investigation of the emm types and superantigen genes of GAS prevalence are imperative.

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“…It becomes a more worrisome issue when patients experience severe infection and impairing symptoms, as when caused by the influenza virus, with possible serious complications [28][29][30]. Although antibiotics can be necessary in case of secondary bacterial colonization [31], they are still too often systematically resorted to, despite local governmental sensitization campaigns [32,33] to promote more appropriate antibiotic use, which has led to the worldwide bacterial resistance crisis [34][35][36].…”

Section: Discussionmentioning

confidence: 99%

A randomized, double-blind, controlled study to evaluate clinical efficacy and safety of novel filmogen osmotic treatment for pharyngitis

Rousse¹,

Schütte²,

Guy³

et al. 2017

Clinical-Investigation

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Background: Pharyngitis is caused principally by primary viral infection: virus growth causes lysis of throat mucosa cells, leading to inflammation, secondary bacterial infection, accumulation of contaminants on the throat, and clinical signs of sore throat infection. Currently available drugs only provide partial therapeutic action or relief. Since pharyngitis is a multifactorial condition, a multi target treatment should be more effective. We tested a novel hypertonic, highly osmotic, filmogen liquid bandage which can mechanically clean the throat surface to quickly alleviate the symptoms while also eliminating their causing pathogens. A clinical trial was conducted to evaluate its efficacy and safety.

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Macrolide and Clindamycin Resistance in Group a Streptococci Isolated From Children With Pharyngitis

Cited by 46 publications

References 13 publications

Molecular epidemiology and antimicrobial resistance of group a streptococcus recovered from patients in Beijing, China

Molecular epidemiology and antimicrobial resistance of group a streptococcus recovered from patients in Beijing, China

Molecular epidemiology and antimicrobial resistance of group A streptococcus recovered from patients in Beijing, China

A randomized, double-blind, controlled study to evaluate clinical efficacy and safety of novel filmogen osmotic treatment for pharyngitis

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