|Reference : Prevalence of ermB, ermTR and mefA/B gene classes among erythromycine resistant group...|
|Scientific congresses and symposiums : Poster|
|Human health sciences : Immunology & infectious disease|
Human health sciences : Laboratory medicine & medical technology
|Prevalence of ermB, ermTR and mefA/B gene classes among erythromycine resistant group B streptococcus isolates collected in Belgium|
|MELIN, Pierrette [Centre Hospitalier Universitaire de Liège - CHU > > Microbiologie médicale >]|
|Rodriguez Cuns, Grisel [Universitad de la Republica, Montevideo, Uruguay > > > >]|
|Tsobo, Chantal [ > > ]|
|HAYETTE, Marie-Pierre [Centre Hospitalier Universitaire de Liège - CHU > > Microbiologie médicale >]|
|CHRISTIAENS, Geneviève [Centre Hospitalier Universitaire de Liège - CHU > > Direction médicale >]|
|De Mol, Patrick [Université de Liège - ULg > Département des sciences biomédicales et précliniques > Microbiologie médicale et virologie médicale >]|
|39th Annual meeting of the Infectious Disease Society of America (IDSA)|
|du 25 au 28 octobre 2001|
|Infectious Disease Society of America - IDSA|
|[en] Group B streptococci ; erythromycin resistance ; resistance mechanism ; resistance genes ; Belgium ; clinical isolates|
|[en] Background: Emergence of erythromycin (Er) and clindamycin (C) resistance (R) observed in GBS, is currently becoming recognized.
Methods: Clinical isolates were obtained from a Belgian surveillance for invasive GBS disease in newborns and adults in 1996-1998 (N1=235) and from consecutive specimens submitted, during 1999-2000, to the University hospital of Liege (N2=165). MICs of Er were determined buy using Etest® strip (interpretive
criteria of NCCLS). Furthermore, for the ErR isolates, the inducible (iMLS), constitutive (cMLS) and M phenotypes were assessed by disk diffusion and by a double-disk test; the distribution of genes encoding RNA methylases and efflux pumps was investigated by PCR.
Results: Of the N1 and N2 isolates, 16 (6.8%) and 19 (11.5%) were respectively R to Er. Among these 35 ErR isolates, 21 (60%) exhibited the cMLS phenotype. They demonstrated a high level R to Er with MICs ranging from 16 to >256 mg/L. The ermB gene was harbored by 19/21 isolates, the ermTR gene by 1 isolate and both ermB and ermTR were present in another isolate. The iMLS phenotype was observed in 10 (29%) ErR isolates; the ermTR gene was present in all isolates except one harboring an ermTR gene. These strains demonstrated low level of R to Er, with MICs of 1-12 mg/L. All 4 isolates (11%) expressing an M phenotype,
displayed low level R to Er alone (MICs, 2 mg/L) and were positive for the mefA/B gene.
Conclusion: In Belgium, by year 2000, prevalence of R to macrolide in GBS exceeded 10%. R was mainly caused by target-site modification (ermB, ermTR) mechanisms; efflux (mefA/B) R mechanism was also prevalent among the isolates tested. These results indicate the possibility of inappropriate prophylaxis
or therapy using C or E as the recommended alternatives in penicillin-allergic patients.
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