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Characterization of erythromycin-resistant Streptococcus pneumoniae isolates causing invasive diseases in Chinese

Xiang Ma1, Kai-hu Yao, Gui-lin Xie

  • 1Key Laboratory of Major Diseases in Children and the National Key Discipline of Pediatrics (Capital Medical University), Ministry of Education, Beijing Pediatrics Research Institute, Beijing Children's Hospital, Beijing 10045, China.

Chinese Medical Journal
|April 19, 2013
PubMed

Insights

Erythromycin resistance in invasive pneumococcal disease (IPD) isolates from Chinese children is high, primarily driven by the ermB gene. Strains with both ermB and mefA genes are mainly serotypes 19A and 19F.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Genetics

Background:

  • Erythromycin-resistant Streptococcus pneumoniae causing invasive pneumococcal diseases (IPD) in Chinese children are poorly understood.
  • This study investigates resistance mechanisms and genetic links among these pediatric IPD isolates.

Purpose of the Study:

  • To identify resistance genes in erythromycin-resistant S. pneumoniae isolates from Chinese children.
  • To determine the genetic relationships of these invasive pneumococcal isolates.

Main Methods:

  • 171 S. pneumoniae strains collected from 11 Chinese medical centers (2006-2008) underwent serotyping and antibiotic susceptibility testing.
  • Erythromycin-resistant isolates were analyzed for ermB and mefA genes, multi-locus sequence typing, and pulsed-field gel electrophoresis.

Main Results:

  • A high prevalence of erythromycin resistance (95.9%) was observed, with 162 strains showing high-level resistance.
  • The ermB gene was present in 63.4% of isolates, while 36.0% carried both ermB and mefA genes.
  • Isolates with both ermB and mefA genes were predominantly serotypes 19A and 19F, exhibiting clonal characteristics linked to the Taiwan(19F)-14 clone.

Conclusions:

  • Erythromycin resistance rates in pediatric IPD isolates in China are notably high.
  • The ermB gene is the primary mediator of erythromycin resistance in these isolates.
  • Co-occurrence of ermB and mefA genes is strongly associated with serotypes 19A and 19F.
Abstract

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