Resistance of Streptococcus Pneumoniae to Macrolides in Iran
Shervin Shokouhi1,2, Ilad Alavi Darazam1,2, Atousa Yazdanpanah1
1Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Background:
Antimicrobial resistance of Streptococcus pneumoniae (S. pneumoniae) has shown major changes in recent years. On the other hand, macrolide antibiotics are being increasingly used in clinical practice. Several studies have reported increased resistance to this group of antibiotics, while there is no comprehensive information in this area. Accordingly, the present study was designed to estimate the resistance of S. pneumoniae to macrolides in Iran.
Materials And Methods:
In this review, articles (2000-2017), evaluating the level and type of S. pneumoniae resistance to macrolides in Iran, were extracted by searching different databases, and the results were analyzed.
Results:
A total of 25 relevant articles were retrieved and analyzed. Overall, 2723 cases had been recruited in these studies. The mean percentage of resistance to macrolides was estimated at 48.43% (CI, 38.8-57.9%). In the majority of reported cases, the resistance mechanisms included ribosomal methylation (i.e., ermB mutation), dual resistance, and efflux-mediated resistance.
Conclusion:
Based on the findings, the resistance rates are considerable in different cities of Iran. Therefore, without determining the type of drug resistance in clinical samples, use of macrolides is not recommended for treatment purposes. In addition, considering the type of resistance mechanisms in Iran, use of higher drug doses is probably ineffective.
Insights
Antimicrobial resistance of Streptococcus pneumoniae to macrolides in Iran is significant, with nearly 50% of cases showing resistance. Understanding resistance mechanisms is crucial before prescribing macrolides.
Area of Science:
- Microbiology
- Infectious Diseases
- Pharmacology
Background:
- Antimicrobial resistance in Streptococcus pneumoniae is evolving.
- Macrolide antibiotic use is increasing globally.
- Comprehensive data on macrolide resistance in S. pneumoniae in Iran is lacking.
Purpose of the Study:
- To estimate the prevalence and patterns of macrolide resistance in Streptococcus pneumoniae in Iran.
- To synthesize existing research on S. pneumoniae macrolide resistance in the Iranian context.
Main Methods:
- Systematic review of studies published between 2000 and 2017.
- Searched multiple databases for relevant articles on S. pneumoniae macrolide resistance in Iran.
- Analyzed data from 25 retrieved articles encompassing 2723 cases.
Main Results:
- The overall mean macrolide resistance rate in S. pneumoniae was 48.43% (95% CI: 38.8-57.9%).
- Common resistance mechanisms identified include ribosomal methylation (ermB mutation), dual resistance, and efflux pumps.
- Resistance rates varied across different Iranian cities.
Conclusions:
- Macrolide resistance in S. pneumoniae is a considerable public health concern in Iran.
- Empirical use of macrolides for S. pneumoniae infections is not recommended without susceptibility testing.
- Higher doses of macrolides may be ineffective due to prevalent resistance mechanisms.
More Related Videos
09:17A Robust Pneumonia Model in Immunocompetent Rodents to Evaluate Antibacterial Efficacy against S. pneumoniae, H. influenzae, K. pneumoniae, P. aeruginosa or A. baumannii
Published on: January 2, 2017
09:59Application of the Intelligent High-Throughput Antimicrobial Sensitivity Testing/Phage Screening System and Lar Index of Antimicrobial Resistance
Published on: July 21, 2023
Related Concept Videos
01:30Development of Antibiotic Resistance
01:31Defense Against Bacterial Pathogens
Phagocytes
Phagocytes are the frontline soldiers of the immune system. They include neutrophils and macrophages. Neutrophils are the most abundant type of white blood cell and are quickly mobilized to the site of infection. Macrophages are larger cells that patrol...