Significant decline in the erythromycin resistance of group A streptococcus isolates at a German paediatric tertiary care centre

Abstract

Group A streptococcus (GAS) is considered to be a major pathogen of bacterial tonsillopharyngitis in children. Although GAS is generally susceptible to penicillin, macrolides are often used as the second-line treatment. Over the last several decades, the rising macrolide resistance of GAS has been detected in several countries. With the current study, we aimed to determine the development of macrolide resistance at our paediatric centre. From March 2006 to May 2009, 350 GAS isolates were tested for susceptibility to erythromycin, azithromycin, clindamycin, penicillin and cefotaxime. Macrolide-resistant isolates were screened for the presence of genes related to macrolide resistance (mefA, ermB, ermTR, prtF1). In comparison to a prior study at our hospital, the erythromycin resistance rate decreased significantly from 13.6 to 2.6%. This effect may be attributable to a more restrictive use of macrolides in children in our region.

Susceptibility of Group AStreptococcusto Antimicrobial Agents in Northern Israel: A Surveillance Study

“…GAS isolates showed a significant decrease of resistance rates to erythromycin, clindamycin, and tetracycline. 6,12,28 Same low rates of resistance were found in additional studies on general populations in Serbia, 21 Turkey, 4 Belgium, 29 and Taiwan. 10 In southern Europe, erythromycin, clindamycin, and tetracycline resistance was shown to have been decreased during 2005 to 2012.…”

“…A wide variability in antimicrobial susceptibility of GAS to macrolides and tetracyclines has been reported in several geographical regions. 3,4,6,10,12,16,19,23,[27][28][29]32 Recent published data from Europe indicate an increase of resistance to macrolides, which is quite a common practice in our region. A nationwide study conducted in Israel during 1996 to 1999 studied 500 GAS isolates from invasive infections.…”

Antimicrobial susceptibility of bacterial isolates from patients presenting with ear, nose and throat (ENT) infections in the German community healthcare setting

“…The resistance rates of macrolides and clindamycin found in the current study are consistent with the average respective values of 3.9% and 0.7% reported for invasive GAS isolates in Germany during the time period 2003-2013 [9]. Another study group investigating the development of macrolide resistance among GAS isolates at a paediatric tertiary care centre in Germany found a significant decline from 13.6% in a first period (1999)(2000)(2001)(2002)(2003) to 2.6% in a second period (March 2006 to May 2009) [10].…”

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

“…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. 5 Kada uporedimo ove podatke dobijamo poprilično veliki opseg rezistencije GAS na eritromicin, u rasponu od 2,6% do 38%. Tako da i rezultati istraživanja za Grad Kraljevo sa rezistencijom bakterije Streptococcus pyogenes na Eritromicin (najčešće primenjivan od makrolidnih antibiotika) od 15% ne pokazuje odstupanje od već dobijenih podataka u medicinskim istraživanjima u svetu.…”