Phenotypes and Genotypes of Erythromycin-resistant Streptococcus Pyogenes Strains Isolated from Invasive and Non-invasive Infections from Mexico and the USA During 1999-2010

Overview

Journal Int J Infect Dis

Publisher Elsevier

Specialty Infectious Diseases

Date 2012 Jan 6

PMID 22217469

Citations 13

Authors

Alberto Villasenor-Sierra

Eva Katahira

Abril N Jaramillo-Valdivia

Maria de los Angeles Barajas-Garcia

Amy Bryant

Rayo Morfin-Otero

Francisco Marquez-Diaz

Juan Carlos Tinoco

Jose Sanchez-Corona

Dennis L Stevens

Affiliations

Soon will be listed here.

Abstract

Objective: To compare the prevalence, phenotypes, and genes responsible for erythromycin resistance among Streptococcus pyogenes isolates from Mexico and the USA.

Methods: Eighty-nine invasive and 378 non-invasive isolates from Mexico, plus 148 invasive, 21 non-invasive, and five unclassified isolates from the USA were studied. Susceptibilities to penicillin, erythromycin, clindamycin, ceftriaxone, and vancomycin were evaluated according to Clinical and Laboratory Standards Institute (CLSI) standards. Phenotypes of erythromycin resistance were identified by triple disk test, and screening for mefA, ermTR, and ermB genes was carried out by PCR.

Results: All isolates were susceptible to penicillin, ceftriaxone, and vancomycin. Erythromycin resistance was found in 4.9% of Mexican strains and 5.2% of USA strains. Phenotypes in Mexican strains were 95% M and 5% cMLS; in strains from the USA, phenotypes were 33.3% iMLS, 33.3% iMLS-D, and 33.3% M. Erythromycin resistance genes in strains from Mexico were mefA (95%) and ermB (5%); USA strains harbored ermTR (56%), mefA (33%), and none (11%). In Mexico, all erythromycin-resistant strains were non-invasive, whereas 89% of strains from the USA were invasive.

Conclusions: Erythromycin resistance continues to exist at low levels in both Mexico and the USA, although the genetic mechanisms responsible differ between the two nations. These genetic differences may be related to the invasive character of the S. pyogenes isolated.

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