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Molecular epidemiology of macrolide-resistant Streptococcus pneumoniae isolates in Europe

Ralf René Reinert1, Adrian Ringelstein, Mark van der Linden

  • 1Institute for Medical Microbiology, National Reference Center for Streptococci, University Hospital, Pauwelsstrasse 30, Aachen, Germany. Reinert@rwth-aachen.de

Journal of Clinical Microbiology
|March 8, 2005
PubMed

Insights

Macrolide resistance in Streptococcus pneumoniae is increasing across Europe, often exceeding penicillin G resistance. Genotype prevalence and clonal spread vary by country, with specific clones like Spain23F-1 being widespread.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Macrolide resistance in Streptococcus pneumoniae is a growing public health concern in Europe.
  • Pneumococcal resistance to macrolides now surpasses resistance to penicillin G in many European nations.

Purpose of the Study:

  • To investigate the prevalence and characteristics of macrolide resistance in Streptococcus pneumoniae isolates across seven European countries.
  • To determine the genetic basis and clonal dissemination of macrolide resistance in these isolates.

Main Methods:

  • Antimicrobial susceptibility testing of 82 erythromycin A-resistant Streptococcus pneumoniae isolates.
  • Multilocus sequence typing (MLST) to analyze clonal relatedness.
  • Characterization of macrolide resistance genotypes (erm(B) and mef(A)).

Main Results:

  • Significant variation in macrolide resistance genotypes (erm(B) vs. mef(A)) was observed between countries.
  • Predominance of erm(B) in France, Spain, Switzerland, and Poland; higher mef(A) prevalence in Greece and Germany.
  • Oligoclonal spread of specific MLST types, notably sequence type 81 (Spain23F-1 clone), was identified as a major driver of resistance.

Conclusions:

  • Macrolide resistance in Streptococcus pneumoniae is driven by the spread of specific resistant clones across Europe.
  • Understanding country-specific genotypic and clonal patterns is crucial for effective antimicrobial stewardship and resistance monitoring.

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