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Erythromycin resistance in group A beta hemolytic streptococcus
S Esposito1, S Noviello, F Ianniello
1Department of Infectious Diseases, Second University, Naples, Italy.
Chemotherapy
|October 2, 1998
Summary
Erythromycin resistance is common in group A beta-hemolytic streptococcus (GABHS) from children with pharyngotonsillitis. The inducible MLS (iMLS) and M phenotypes are most prevalent, suggesting newer macrolides may be effective.
Area of Science:
- Microbiology
- Infectious Diseases
- Pharmacology
Background:
- Group A beta-hemolytic streptococcus (GABHS) is a common cause of acute pharyngotonsillitis in children.
- Antibiotic resistance, particularly to erythromycin, is a growing concern in managing GABHS infections.
Purpose of the Study:
- To determine the incidence and phenotypic patterns of erythromycin resistance in GABHS strains.
- To evaluate the implications of observed resistance patterns for macrolide therapy.
Main Methods:
- Isolation and identification of 130 GABHS strains from throat swabs of children with acute pharyngotonsillitis.
- Phenotypic characterization of erythromycin resistance, including cMLS, iMLS, and M phenotypes.
Main Results:
- A significant proportion (43%) of GABHS strains exhibited erythromycin resistance.
- The inducible MLS (iMLS) and M phenotypes were the most common resistance patterns, observed in 32.1% and 55.3% of resistant strains, respectively.
- Constitutive MLS (cMLS) phenotype was less frequent (12.5%).
Conclusions:
- Erythromycin resistance is prevalent in pediatric GABHS isolates, with iMLS and M phenotypes dominating.
- The susceptibility to newer macrolides with higher tissue concentrations may offer therapeutic alternatives for these resistant strains.