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Clonal spread of mef-positive macrolide-resistant Streptococcus pneumoniae isolates causing invasive disease in

Mark van der Linden1, Adnan Al-Lahham, Stefan Haupts

  • 1Institute for Medical Microbiology, National Reference Center for Streptococci, University Hospital, Pauwelsstr 30, Aachen, Germany.

Antimicrobial Agents and Chemotherapy
|February 28, 2007
PubMed

Insights

Erythromycin resistance in invasive pneumococcal disease rose significantly in German adults from 1992-2004. The erm(B) and mef genes were common, with a serotype 14, sequence type 9 clone being most prevalent.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Invasive pneumococcal disease (IPD) remains a significant public health concern.
  • Macrolide antibiotics are crucial for treating bacterial infections, including IPD.
  • Monitoring antimicrobial resistance patterns is essential for effective treatment strategies.

Purpose of the Study:

  • To investigate the prevalence and trends of erythromycin resistance in Streptococcus pneumoniae isolates from German adults with IPD.
  • To identify the genetic mechanisms conferring macrolide resistance.
  • To determine the molecular epidemiology of resistant isolates.

Main Methods:

  • Analysis of 3,845 S. pneumoniae isolates from German adults with IPD (1992-2004).
  • Determination of erythromycin nonsusceptibility.
  • Genotyping for macrolide resistance genes (erm(B), mef).
  • Multilocus sequence typing (MLST) for clonal analysis.

Main Results:

  • 11.2% (430/3,845) of isolates were nonsusceptible to erythromycin.
  • Erythromycin resistance frequency increased significantly from 2.2% to 17.0% between 1992 and 2004 (P < 0.001).
  • The erm(B) gene was present in 35.6% and the mef gene in 63.5% of resistant isolates.
  • A dominant clone, serotype 14/sequence type 9, was identified as the most widespread.

Conclusions:

  • A substantial increase in erythromycin resistance among S. pneumoniae causing IPD in German adults was observed.
  • The erm(B) and mef genes are key determinants of macrolide resistance in these isolates.
  • The emergence and spread of specific clones, like serotype 14/ST9, contribute to the epidemiology of antibiotic resistance.

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