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JAC Advance Access originally published online on September 19, 2005
Journal of Antimicrobial Chemotherapy 2005 56(5):841-846; doi:10.1093/jac/dki327
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© The Author 2005. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

mef(A), mef(E) and a new mef allele in macrolide-resistant Streptococcus spp. isolates from Norway

Maria Sangvik1, Pia Littauer1, Gunnar Skov Simonsen1,2, Arnfinn Sundsfjord1,2,* and Kristin Hegstad Dahl1

1 Reference Centre for Detection of Antimicrobial Resistance, Department of Microbiology, University Hospital of North Norway (UNN) and Department of Microbiology and Virology, Institute of Medical Biology, Faculty of Medicine, University of Tromsø, N-9037 Tromsø, Norway; 2 Division of Infectious Disease Control, Norwegian Institute of Public Health, Pb 4404 Nydalen, N-0403 Oslo, Norway

Received 22 June 2005; returned 27 July 2005; revised 12 August 2005; accepted 17 August 2005

* Corresponding author. Tel: +47-77-64-62-02; Fax: +47-77-64-53-50; E-mail: arnfinns{at}fagmed.uit.no

Objectives: To type mef genes in a nationwide collection of clinical isolates of Streptococcus pneumoniae and Streptococcus pyogenes as well as pharyngeal carrier strains of viridans streptococci in Norway.

Methods: Erythromycin-resistant mef-positive multilocus sequence-typed (MLST) clinical isolates of S. pneumoniae (n = 36) and S. pyogenes (n = 12) from the National Surveillance Program for Antimicrobial Resistance (NORM) as well as viridans streptococci (n = 20) from healthy adults were included. PCR-amplified mef genes were initially discriminated by BamHI digestion. Selected mef genes from representatives of different sequence types (STs) of S. pneumoniae (n = 11) and S. pyogenes (n = 4), and viridans group streptococcal species (n = 8) were typed by sequencing and their strains examined for co-resistances. Hydropathy plots of different mef-encoded proteins were performed.

Results: A predominance of mef(A) was detected in S. pneumoniae (23/36) and S. pyogenes (9/12) due to the clonal spread of ST9 and ST39, respectively. mef(E) was the most widely distributed mef determinant occurring in nine different STs of S. pneumoniae and in four different viridans species. A new mef allele was identified in two STs of S. pyogenes.

Conclusions: mef(E) is the most widely distributed mef determinant in Norwegian clinical strains of S. pneumoniae and pharyngeal carrier strains of various viridans streptococci. However, mef(A) is more prevalent in S. pneumoniae and S. pyogenes due to clonal spread. A new mef allele was found in two different STs of S. pyogenes.

Keywords: macrolide efflux , erythromycin , M-type resistance , Major Facilitator Superfamily


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