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Detection of Macrolide-Resistant Streptococcus pneumoniae Genes and Its Clinical Outcomes in a Tertiary Teaching

Wan Norliyana Wan Mahmud1, Siti Asma' Hassan2, Zaidah Abd Rahman2

  • 1Hospital Kemaman, Terengganu, Malaysia.

The Malaysian Journal of Medical Sciences : MJMS
|May 2, 2024
PubMed
Abstract

Insights

Drug-resistant Streptococcus pneumoniae poses a significant global health threat. This study found macrolide resistance in pneumococcal infections, primarily linked to the mef(A) gene, without impacting mortality or complications.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Streptococcus pneumoniae causes significant global mortality and morbidity.
  • Increasing antimicrobial resistance, especially to beta-lactams and macrolides, complicates pneumococcal infection treatment.
  • This study investigated drug resistance and macrolide-resistant genes in pneumococcal infections at Hospital Universiti Sains Malaysia.

Purpose of the Study:

  • To determine the drug resistance rates of Streptococcus pneumoniae isolates.
  • To assess the prevalence of macrolide-resistant genes in these isolates.
  • To review the clinical complications associated with pneumococcal infections.

Main Methods:

  • Descriptive cross-sectional study design.
  • Antimicrobial susceptibility testing using E-test strips for S. pneumoniae isolates.
  • Polymerase chain reaction (PCR) to detect macrolide-resistant determinants (mef(A) and erm(B)).

Main Results:

  • Penicillin resistance was 7.1% and erythromycin resistance was 26.5%.
  • The mef(A) gene was the most prevalent macrolide resistance determinant (50.4%), followed by erm(B) (20%).
  • No significant association was found between macrolide resistance determinants and mortality or specific complications.

Conclusions:

  • The mef(A) gene is the primary driver of macrolide resistance in S. pneumoniae isolates studied.
  • Erythromycin-resistant isolates frequently carried mef(A), erm(B), or both.
  • Understanding resistance patterns is crucial for effective pneumococcal infection management.
Keywords:
Streptococcus pneumoniaegenesmacrolideresistantsusceptibility

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