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Macrolide resistance in Streptococcus pneumoniae isolated from Argentinian pediatric patients suffering from acute

Vanesa Reijtman1, Paula Gagetti2, Diego Faccone2

  • 1Servicio de Microbiología, Hospital de Pediatría "Prof. Dr. J. P. Garrahan", Buenos Aires, Argentina.

Revista Argentina De Microbiologia
|January 10, 2014
PubMed

Insights

Macrolide resistance in Streptococcus pneumoniae is a growing concern. This study found the mefA gene is the primary mechanism for erythromycin resistance in pediatric acute otitis media isolates in Argentina.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pediatrics

Background:

  • Macrolide-resistant Streptococcus pneumoniae (MRSP) emerged in Argentina in 1995.
  • MRSP represented 26% of invasive infection isolates in children under 5 years old.
  • Understanding resistance mechanisms and genetic relatedness is crucial for effective treatment.

Purpose of the Study:

  • To determine the prevalence of ermB and mefA genes in macrolide-resistant S. pneumoniae isolates from pediatric acute otitis media (AOM).
  • To analyze the genetic relatedness of these resistant isolates.
  • To provide insights into the molecular epidemiology of MRSP in Argentina.

Main Methods:

  • Collection of 126 S. pneumoniae isolates from 324 children with AOM between May 2009 and August 2010.
  • Phenotypic detection of erythromycin resistance.
  • Molecular detection of ermB and mefA resistance genes using PCR.
  • Serotyping and genotyping (MLST) to determine genetic relatedness.

Main Results:

  • Twenty-six isolates (20.6%) exhibited erythromycin resistance.
  • The mefA gene was the most prevalent resistance mechanism (76.9%), followed by ermB (19.2%).
  • Ten distinct clonal types were identified, with notable associations to specific serotypes and sequence types.

Conclusions:

  • The mefA gene is the predominant mechanism of macrolide resistance in S. pneumoniae causing AOM in Argentine children.
  • Genetic relatedness analysis revealed the circulation of specific MRSP clones.
  • This study is the first to assess macrolide resistance mechanisms and genetic relatedness in pneumococcal isolates from pediatric AOM in Argentina.
Keywords:
Acute otitis mediaMacrolide resistanceOtitis media agudaResistencia a macrólidosStreptococcus pneumoniae

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