JAC Advance Access originally published online on April 29, 2004
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Journal of Antimicrobial Chemotherapy (2004) 53, 1095-1097
© 2004 The British Society for Antimicrobial Chemotherapy
Antimicrobial susceptibility patterns and macrolide resistance genes of viridans group streptococci from blood cultures in Korea
1 Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Ilsan-dong 162, Wonju, Kangwon-do; 2 Department of Laboratory Medicine, Hallym College of Medicine, Chuncheon; 3 Department of Infectious Disease, Yonsei University Wonju College of Medicine, Wonju, South Korea
Received 7 November 2003; returned 19 January 2004; revised and accepted 2 March 2004
Objectives: Our aim was to study the antimicrobial susceptibilities and macrolide resistance mechanisms of viridans group streptococci (VGS) in a Korean tertiary hospital.
Methods: MICs of five antimicrobials were determined for 106 VGS isolated from blood cultures. The macrolide resistance mechanisms of erythromycin non-susceptible isolates were studied by the double-disc test and PCR.
Results: In all, 42.4% of the isolates were susceptible to penicillin. Nine of 61 penicillin non-susceptible isolates were fully resistant (MIC 
4 mg/L). Rates of non-susceptibility to erythromycin, clindamycin and ceftriaxone were 33.9%, 17.9% and 9.4%, respectively. Twenty-two (61.1%) of 36 erythromycin non-susceptible isolates expressed constitutive resistance to macrolide–lincosamide–streptogramin B antibiotics (a constitutive MLSB phenotype); 13 isolates (36.1%) expressed an M phenotype; and one isolate, a Streptococcus bovis isolate, had an inducible MLSB resistance phenotype. erm(B) was found in isolates with constitutive/inducible MLSB phenotypes, and mef(A) in isolates with the M phenotype. In three isolates (two isolates with a constitutive MLSB phenotype and in one isolate with the M phenotype), none of erm(A), erm(B), erm(C) or mef(A) was detected by PCR.
Conclusions: Penicillin non-susceptible VGS were more resistant to erythromycin, clindamycin and ceftriaxone than were penicillin-susceptible isolates. A constitutive MLSB phenotype associated with erm(B) was the predominant mechanism of macrolide resistance among erythromycin non-susceptible isolates from this Korean hospital.
Keywords: 
-haemolytic streptococci, erythromycin resistance, MLSB phenotype, erm(B), mef(A)
* Corresponding author. Tel: +82-33-741-1592; Fax: +82-33-731-0506; E-mail: u931018{at}wonju.yonsei.ac.kr
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