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- Title
Increasing telithromycin resistance among Streptococcus pyogenes in Europe.
- Authors
Sandra S. Richter; Kristopher P. Heilmann; Cassie L. Dohrn; Susan E. Beekmann; Fathollah Riahi; Juan Garcia-de-Lomas; Matus Ferech; Herman Goossens; Gary V. Doern
- Abstract
: Objectives To assess changes in macrolide and ketolide resistance among Streptococcus pyogenes in Europe and to examine the relationship of resistance to antimicrobial usage. : Methods Clinical S. pyogenes isolates were collected from Denmark, Finland, France, Germany, Italy, Netherlands, Norway, Spain, Sweden, UK, Croatia, Hungary, Poland, Slovak Republic and Slovenia during 2002–03 (n = 2165) and 2004–05 (n = 2333). Resistance to telithromycin (MIC ≥2) and erythromycin (MIC ≥0.5) was determined by CLSI broth microdilution. Changes in resistance over time and the relationship of resistance to antimicrobial use (European Surveillance of Antimicrobial Consumption data) were assessed. Telithromycin-resistant isolates were characterized by PFGE to determine genetic relatedness and by PCR to detect mef(A), erm(A) and erm(B). : Results The erythromycin resistance rate during 2004–05 (11.6%) was similar to 2002–03 (10.4%). The proportion of macrolide-resistant isolates with the constitutive MLSB phenotype increased from 29.3% (2002–03) to 45.7% (2004–05). Telithromycin resistance increased from 1.8% in 2002–03 to 5.2% in 2004–05. For Western Europe, associations of telithromycin and erythromycin resistance, respectively, were found with azithromycin use (R2 = 0.52 and 0.60), clarithromycin use (R2 = 0.76 and 0.85) and total macrolide/lincosamide use (R2 = 0.75 and 0.69). For Eastern Europe, associations of antimicrobial use with resistance were not apparent. The 162 telithromycin-resistant isolates comprised 42 PFGE patterns with 68.5% in eight major PFGE groups. The erm(B) gene was detected in 155 of the 162 telithromycin-resistant isolates. : Conclusions Significant increases in telithromycin resistance occurred from 2002–03 to 2004–05 in Europe. Macrolide use appears to be a factor in the emergence of ketolide resistance among S. pyogenes in Western Europe.
- Subjects
EUROPE; DRUG resistance in microorganisms; MACROLIDE antibiotics; STREPTOCOCCUS pyogenes
- Publication
Journal of Antimicrobial Chemotherapy (JAC), 2008, Vol 61, Issue 3, p603
- ISSN
0305-7453
- Publication type
Article
- DOI
10.1093/jac/dkm525