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Erythromycin-resistant pharyngeal isolates of Streptococcus pyogenes recovered in Italy
Giordano Dicuonzo1, Ersilia Fiscarelli, Giovanni Gherardi
1Department of Laboratory Medicine. Hospital Infection Control Program, Università Campus Bio-Medico, Rome, Italy.
Abstract:
Three classes of macrolide resistance phenotypes and three different erythromycin resistance determinants were found among 127 erythromycin-resistant group A streptococcal (GAS) isolates recovered from 355 (35.8%) pediatric pharyngitis patients in Rome, Italy. According to emm and sof sequence typing results, erythromycin-resistant isolates comprised 11 different clonal types. Remarkably, 126 of the 127 macrolide-resistant isolates were serum opacity factor (sof) gene positive. These data suggest a strong association between macrolide resistance and the presence of sof among GAS isolates recovered from Italian pediatric pharyngitis patients.
Insights
Macrolide resistance in group A Streptococcus (GAS) is linked to the serum opacity factor (sof) gene in Italian pediatric patients. This finding highlights a potential marker for antibiotic resistance in pharyngitis cases.
Area of Science:
- Microbiology
- Infectious Diseases
- Molecular Epidemiology
Background:
- Group A Streptococcus (GAS) is a significant cause of pediatric pharyngitis.
- Macrolide antibiotics are commonly used to treat GAS infections.
- Emergence of antibiotic resistance in GAS is a growing public health concern.
Purpose of the Study:
- To investigate macrolide resistance phenotypes and determinants in GAS isolates from pediatric pharyngitis patients.
- To determine the clonal types and genetic basis of erythromycin resistance in GAS.
- To explore the association between macrolide resistance and the presence of the serum opacity factor (sof) gene.
Main Methods:
- Collection and analysis of 127 erythromycin-resistant GAS isolates from 355 pediatric pharyngitis patients in Rome, Italy.
- Phenotypic characterization of macrolide resistance.
- Molecular analysis including emm and sof sequence typing.
Main Results:
- Three distinct macrolide resistance phenotypes and three erythromycin resistance determinants were identified.
- Erythromycin-resistant GAS isolates belonged to 11 different clonal types based on emm and sof typing.
- A strong association was observed between macrolide resistance and the presence of the sof gene, with 126 out of 127 resistant isolates being sof-positive.
Conclusions:
- The study identified a significant association between macrolide resistance and the presence of the serum opacity factor (sof) gene in GAS isolates from Italian pediatric pharyngitis patients.
- The findings suggest that sof gene presence could be a potential indicator for macrolide resistance in GAS.
- This research contributes to understanding the epidemiology of antibiotic resistance in GAS and has implications for treatment strategies.