RESUMO
Resistance of group B streptococcus (GBS) to antibiotics, particularly erythromycin and clindamycin, was studied. Erythromycin resistance was present in 22% of GBS isolates, and these isolates were constitutively resistant, inducibly resistant, or sensitive to clindamycin. Erythromycin and clindamycin MICs were related to the presence of ermA, ermB, or mefA genes.
Assuntos
Antibacterianos/farmacologia , Clindamicina/farmacologia , Eritromicina/farmacologia , Testes de Sensibilidade Microbiana/métodos , Streptococcus agalactiae/efeitos dos fármacos , Ágar , Proteínas de Bactérias/genética , Difusão , Farmacorresistência Bacteriana/genética , Humanos , Proteínas de Membrana/genética , Metiltransferases/genética , Streptococcus agalactiae/genética , Streptococcus agalactiae/isolamento & purificaçãoRESUMO
Macrolide (including erythromycin and azithromycin) and lincosamide (including clindamycin) antibiotics are recommended for treatment of penicillin-allergic patients with Streptococcus pyogenes pharyngitis. Resistance to erythromycin in S. pyogenes can be as high as 48% in specific populations in the United States. Macrolide and lincosamide resistance in S. pyogenes is mediated by several different genes. Expression of the erm(A) or erm(B) genes causes resistance to erythromycin and inducible or constitutive resistance to clindamycin, respectively, whereas expression of the mef(A) gene leads to resistance to erythromycin but not clindamycin. We studied the resistance of S. pyogenes to erythromycin and clindamycin at an urban tertiary-care hospital. Of 196 sequential isolates from throat cultures, 15 (7.7%) were resistant to erythromycin. Three of these were also constitutively resistant to clindamycin and had the erm(B) gene. Five of the erythromycin-resistant isolates were resistant to clindamycin upon induction with erythromycin and had the erm(A) gene. The remaining seven erythromycin-resistant isolates were susceptible to clindamycin even upon induction with erythromycin and had the mef(A) gene. Pulsed-field gel electrophoresis analysis and emm typing demonstrated that the erythromycin-resistant S. pyogenes comprised multiple strains. These results demonstrate that multiple mechanisms of resistance to macrolide and lincosamide antibiotics are present in S. pyogenes strains in the United States.
Assuntos
Antibacterianos/farmacologia , Clindamicina/farmacologia , Farmacorresistência Bacteriana/genética , Eritromicina/farmacologia , Streptococcus pyogenes/efeitos dos fármacos , Antígenos de Bactérias/genética , Proteínas da Membrana Bacteriana Externa/genética , Proteínas de Bactérias/genética , Proteínas de Bactérias/metabolismo , Proteínas de Transporte/genética , Humanos , Lincosamidas , Macrolídeos/farmacologia , Testes de Sensibilidade Microbiana , Dados de Sequência Molecular , Faringe/microbiologia , Análise de Sequência de DNA , Infecções Estreptocócicas/microbiologiaRESUMO
BACKGROUND: Respiratory infections are the leading cause of outpatient visits in the United States, but the etiology of many of these infections is unknown. Human metapneumovirus (hMPV) is a recently discovered virus that causes respiratory infections. METHODS: Respiratory specimens obtained from patients Assuntos
Hospitais
, Metapneumovirus/isolamento & purificação
, Infecções por Paramyxoviridae/epidemiologia
, Infecções Respiratórias/epidemiologia
, Boston/epidemiologia
, Criança
, Pré-Escolar
, Feminino
, Humanos
, Lactente
, Recém-Nascido
, Masculino
, Infecções por Paramyxoviridae/virologia
, Infecções Respiratórias/virologia
, Estudos Retrospectivos
, Fatores de Risco