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Gradient plate method to induce Streptococcus pyogenes resistance.

H Carsenti-Etesse1, P M Roger, B Dunais

  • 1University Hospital, Nice, France. episud@mail.azur.fr

The Journal of Antimicrobial Chemotherapy
|December 10, 1999
PubMed
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Emerging macrolide resistance in Streptococcus pyogenes (GAS) is a growing concern. This study found that while GAS strains remained susceptible to beta-lactams after antibiotic exposure, erythromycin resistance developed rapidly.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Increasing reports of macrolide-resistant Streptococcus pyogenes (GAS) globally.
  • Antibiotic use is a known risk factor for drug-resistant streptococcal infections and carriage.

Purpose of the Study:

  • To compare the in vitro development of resistance in GAS to beta-lactams and erythromycin.
  • To investigate resistance development through serial passages in sub-inhibitory antibiotic concentrations.

Main Methods:

  • Utilized the gradient plate method for serial passages of three clinical GAS strains.
  • Exposed strains to sub-minimum inhibitory concentrations (subMICs) of beta-lactams and erythromycin.
  • Monitored changes in Minimum Inhibitory Concentrations (MICs) until a four-fold increase was observed.

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Main Results:

  • GAS strains exposed to beta-lactams showed at least a four-fold increase in MICs but remained susceptible.
  • Exposure to erythromycin led to intermediate and resistant levels of MICs.
  • Developed GAS variants demonstrated increased resistance to erythromycin.

Conclusions:

  • GAS strains readily develop resistance to erythromycin but not to beta-lactams under laboratory conditions.
  • Prior exposure to macrolides may facilitate the emergence of drug-resistant Streptococcus pyogenes strains.
  • Findings correlate with clinical observations of increasing macrolide resistance.