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Updated: Jun 24, 2026
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Isolation and Identification of Waterborne Antibiotic-Resistant Bacteria and Molecular Characterization of their Antibiotic Resistance Genes
Published on: March 3, 2023
Antibiotic consumption and link to resistance.
1Department of Medical Microbiology, University Hospital Antwerp, Antwerp, Belgium. Herman.Goossens@uza.be
Summary
Antibiotic resistance in Streptococcus pneumoniae is increasing due to macrolide use. European countries show higher resistance linked to clarithromycin, while the US sees more resistance from azithromycin, driven by different resistance genes.
Area of Science:
- Microbiology
- Pharmacology
- Public Health
Background:
- Antibiotic use for respiratory infections is prevalent in primary care.
- High antibiotic consumption, particularly in Southern Europe, correlates with increased antibiotic resistance in streptococci.
- Macrolide antibiotics are frequently used for respiratory infections, with differing prescribing patterns between the USA and Europe.
Purpose of the Study:
- To investigate the relationship between macrolide antibiotic consumption and the prevalence of resistance mechanisms in Streptococcus pneumoniae.
- To compare macrolide resistance patterns in Europe and the USA.
- To identify the specific genes responsible for macrolide resistance in different geographical regions.
Main Methods:
- Analysis of antibiotic consumption data from the European Surveillance of Antimicrobial Consumption (ESAC) program.
- Comparison of outpatient antibiotic prescribing data between the USA and European countries.
- Surveillance of macrolide resistance mechanisms (erm and mef genes) in Streptococcus pneumoniae isolates.
Main Results:
- Macrolide resistance in Streptococcus pneumoniae is mediated by the erm and mef genes.
- In the USA, the mef gene was primarily responsible for macrolide resistance, while in Europe, the erm(B) gene predominated.
- Higher consumption of clarithromycin in Europe correlated with a higher prevalence of erm(B)-carrying Streptococcus pneumoniae, causing 84% of resistance.
Conclusions:
- Prescribing patterns of macrolides influence the prevalence of specific resistance genes in Streptococcus pneumoniae.
- The erm(B) gene is a significant driver of macrolide resistance in Europe, associated with clarithromycin use.
- Understanding regional differences in antibiotic use and resistance mechanisms is crucial for antimicrobial stewardship.
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