Molecular Basis for Erythromycin Resistance in Group A Streptococcus Isolated From Skin and Soft Tissue Infections

Shivekar, Sunil; Menon, Thangam

doi:10.7860/jcdr/2015/14744.6843

Cited by 2 publications

(4 citation statements)

References 20 publications

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“…In this study we observed that the erythromycin resistance was 48.8% among invasive strains (n = 21/43) and 52.3% among non-invasive strains (n = 68/130). Earlier studies from India have reported the prevalence of M type [18], but given our data the iMLS phenotype was predominant (67.4%), followed by M phenotype (32.5%) which is in agreement with a recent study from Chennai [16]. Isolates with the iMLS phenotype showed high-level resistance to erythromycin (MIC90 ≥ 256 µg/mL) and inducible resistance to clindamycin, whereas those with M phenotypes showed lower erythromycin resistance values and good susceptibility to clindamycin.…”

Section: Discussionsupporting

confidence: 93%

“…In the present study we report an overall erythromycin resistance of 51.4% which is very high comparing to reports from other parts of India [16,17]. In this study we observed that the erythromycin resistance was 48.8% among invasive strains (n = 21/43) and 52.3% among non-invasive strains (n = 68/130).…”

Section: Discussionsupporting

confidence: 46%

“…The genetic determinants of macrolide resistance in Indian GAS population have not been extensively studied. The only Indian study discussing the genetic basis of macrolide resistance showed the predominance of ermB gene [16]. Our findings reveal a predominance of ermB gene (65.1%) followed by mefA gene (32.5%).…”

Section: Discussionmentioning

confidence: 45%

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

Abraham

Sistla

2017

J Infect Dev Ctries

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Introduction: In penicillin allergic patients, macrolides are the most commonly used antibiotics for treating streptococcal infections, irrespective of the higher resistance rates. The objective of this study was to evaluate the comparative prevalence, phenotypes, and genetic determinants of macrolide resistance and associated emm types among different clinical isolates of Streptococcus pyogenes. Methodology: A total of 173 Streptococcus pyogenes isolates were examined for macrolide resistance phenotype by double-disc test, resistance determinants by multiplex PCR and emm genotyping. Results: Erythromycin resistance was found in 51.4% of isolates, with MIC90 ≥ 256 µg/mL Inducible phenotype was commonly found (iMLS, 67.4%) followed by the M phenotype (32.5%). Among these isolates, 65.1% harboured ermB and 32.5% mefA as sole macrolide resistance gene, whereas presence of both, ermB plus mefA was observed in 2.2% cases. The most common types among resistant strains were emm63 (11.2%), emm44 (6.7%), emm42 (5.6%), and emm75. 3, emm82, emm85, emm92, emm111.1 (4.4% each). Statistically significant association was observed between emm63, emm44 and erythromycin resistance (p ≤ 0.05). Association of these emm types and macrolide resistance have not been reported earlier.Conclusion: Higher macrolide resistance in this study can be attributed to overuse and misuse of this antibiotic. These findings indicate that macrolides should not be empirically used for treating severe streptococcal infections.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 46%

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

Abraham

Sistla

2017

J Infect Dev Ctries

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“…Erythromycin was previously recommended as an alternative antibiotic for women at high risk of anaphylaxis. However, due to the evolution of macrolide resistance, current guidelines no longer recommend erythromycin. − While aminoglycosides and tetracyclines are not used to treat GBS infection, the prevalence of GBS resistance to these classes made these antibiotics intriguing areas of focus for combination therapies . Their modes of action could also assist with mechanistic analysis.…”

Section: Resultsmentioning

confidence: 99%

Human Milk Oligosaccharides (HMOs) Sensitize Group B Streptococcus to Clindamycin, Erythromycin, Gentamicin, and Minocycline on a Strain Specific Basis

2018

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Human milk oligosaccharides (HMOs) possess antimicrobial and antibiofilm activity against Group B Streptococcus (GBS). HMOs were screened for their ability to potentiate antibiotic activity. We observed that HMOs potentiate the function of aminoglycosides, lincosamides, macrolides, and tetracyclines on a strain specific basis but not β-lactams or glycopeptides that inhibit cell wall synthesis. These findings are notable as GBS has evolved high levels of resistance toward aminoglycosides, macrolides, and tetracyclines. Finally, HMOs potentiate the function of aminoglycosides against both Staphylococcus aureus and Acinetobacter baumannii. On the basis of these observations, we hypothesized that HMOs act by increasing membrane permeability. This hypothesis was evaluated using a bacterial membrane permeability assay which revealed that HMOs increase membrane permeability toward propidium iodide.

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Molecular Basis for Erythromycin Resistance in Group A Streptococcus Isolated From Skin and Soft Tissue Infections

Cited by 2 publications

References 20 publications

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

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

Human Milk Oligosaccharides (HMOs) Sensitize Group B Streptococcus to Clindamycin, Erythromycin, Gentamicin, and Minocycline on a Strain Specific Basis

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