Characterization of macrolide resistance in Gram-positive cocci from Colombian hospitals: a countrywide surveillance

• Published in: International journal of infectious diseases Vol. 11; no. 4; pp. 329 - 336
• Main Authors: Reyes, Jinnethe, Hidalgo, Marylin, Díaz, Lorena, Rincón, Sandra, Moreno, Jaime, Vanegas, Natasha, Castañeda, Elizabeth, Arias, César A
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ltd 01-07-2007; Elsevier
• Subjects: Anti-Bacterial Agents - pharmacology; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antimicrobial drug resistance; Bacterial diseases; Biological and medical sciences; Colombia - epidemiology; Drug Resistance, Multiple, Bacterial; Electrophoresis, Gel, Pulsed-Field - methods; Enterococcus; Genotype; Gram-Positive Bacterial Infections - drug therapy; Gram-Positive Bacterial Infections - epidemiology; Gram-Positive Bacterial Infections - microbiology; Gram-Positive Cocci - drug effects; Gram-Positive Cocci - genetics; Gram-Positive Cocci - isolation & purification; Human bacterial diseases; Humans; Infectious Disease; Infectious diseases; Macrolides; Macrolides - pharmacology; Medical sciences; Microbial Sensitivity Tests; Pharmacology. Drug treatments; Phenotype; Pulmonary/Respiratory; Staphylococcal infections, streptococcal infections, pneumococcal infections; Staphylococcus; Streptococcus pneumoniae; Colombia; Enterococcus; Antimicrobial drug resistance; Macrolides; Staphylococcus; Streptococcus pneumoniae; Enterococcus faecalis; Drug susceptibility test; Clindamycin; Meticillin; Penicillin derivatives; Pulsed field electrophoresis; Gram positive bacteria; Streptococcal infection; Bacteria; Micrococcales; Micrococcaceae; Protein synthesis inhibitor; Hospital; Pneumococcal infection; Staphylococcus aureus; Treatment resistance; β-Lactams; Erythromycin; Macrolide; Infection; Streptococcaceae; Enterococcus faecium; Antibiotic; Staphylococcus epidermidis; Surveillance; Bacteriosis; Antibacterial agent; Staphylococcal infection
• ISSN: 1201-9712; 1878-3511
• DOI: 10.1016/j.ijid.2006.09.005

Summary Objective The characterization of macrolide resistance in Gram-positive cocci recovered from Colombian hospitals. Methods The resistance profiles and mechanism of macrolide resistance were investigated in isolates of Streptococcus pneumoniae (1679), Staphylococcus aureus (348), coagulase-negative staphylococci (CoNS) (175), and Enterococcus spp (123). Minimum inhibitory concentrations (MICs) for erythromycin (ERY) and clindamycin (CLI), detection of macrolide resistance genes, phenotypic characterization, and pulsed field gel electrophoresis (PFGE) of macrolide-resistant pneumococci were performed. Results Resistance to ERY and CLI was 3.3% and 2.3% for S. pneumoniae , 58% and 57% for S. aureus (94% for both compounds in methicillin-resistant Staphylococcus aureus (MRSA)), and 78.6% and 60.7% in methicillin-resistant Staphylococcus epidermidis , respectively. ERY resistance was 62% in Enterococcus faecalis and 82% in Enterococcus faecium . The MLSB -type accounted for 71% of S. pneumoniae and 100% of MRSA. The erm (A) gene was prevalent in MRSA, erm (B) in S. pneumoniae and enterococci, and erm (C) in CoNS isolates. Efflux pump genes ( mef (A) genes) were mostly identified in S. pneumoniae (24%). The most common genotype amongst ERY-resistant pneumococci was the Spain6B -2 clone. Conclusions The prevalence of macrolide resistance is low in Colombian pneumococci and high in MRSA (cMLSB -type).