Molecular Epidemiology of Macrolide-Resistant Streptococcus pneumoniae Isolates in Europe

Abstract

In many European countries, the level of pneumococcal resistance to macrolides has now passed the level of resistance to penicillin G. A total of 82 erythromycin A-resistant isolates of Streptococcus pneumoniae were collected by 11 laboratories in seven European countries. All of the isolates were tested for antimicrobial susceptibility, analyzed for clonal relatedness by multilocus sequence typing, and characterized for macrolide resistance genotypes. The prevalence of the macrolide resistance genotypes varied substantially between countries. In France (87.5% of all strains), Spain (77.3%), Switzerland (80%), and Poland (100%), strains were predominantly erm(B) positive, whereas higher levels of mef(A)-positive strains were reported from Greece (100%) and Germany (33.3%). Macrolide resistance was caused by the oligoclonal spread of some multilocus sequence types, but significant differences in clonal distribution were noted between France and Spain, countries from which high levels of macrolide resistance have been reported. Overall, sequence type 81 (Spain23F-1 clone) was by far the most widespread. The mainly erm(B)-positive serotype 14 clone (sequence type 143), first reported in Poland in the mid-1990s, is now widespread in France.

Greatest International ANtiinfective Trial (GIANT) with moxifloxacin in the treatment of acute exacerbation of  chronic bronchitis: subanalysis of Chinese data of a global, multicenter, noninterventional study

“…Currently, fluoroquinolone resistance in respiratory pathogens is low, but there are strong links between rates of consumption and resistance. 5 Significant relationships between increased fluoroquinolone use and reduced percentage susceptibility have also been demonstrated for a group of 11 bacterial pathogens (P  0.05). 6 The studies for the new fluoroquinolone, moxifloxacin, have demonstrated that mutations in the target genes require more than one mutation.…”

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“…El fenotipo más frecuentemente identificado fue el cMLS, similar a los resultados del estudio realizado en Colombia en el año 2004 (10) y a los análisis hechos en Francia, España, Suiza y Polonia (21,27), mientras que en otros países, como Grecia, Alemania, Chile y un estudio reciente publicado en Argentina, el fenotipo M es el más importante (5,25,28,29).…”

Genetic determinants of antibiotic resistance in oropharyngeal streptococci in patients with chronic obstructive pulmonary disease and in those with asthma

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“…Другой путь связан с приобретением генов mef, коди-рующих зависимые от ATФ белки, активно выводящие антибиотики из бактериальной клетки. Наличие генов mef приводит к слабой устойчивости к макролидам, и микро-организм остается чувствительным к клиндамицину [14]. При этом резервуаром генетических детерминант устой-чивости считаются непатогенные S. mitis и S. oralis.…”