JAC Advance Access originally published online on June 12, 2003
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Journal of Antimicrobial Chemotherapy (2003) 52, 50-55
© 2003 The British Society for Antimicrobial Chemotherapy
Streptococcus pyogenes isolates with characterized macrolide resistance mechanisms in Spain: in vitro activities of telithromycin and cethromycin
Servicio de Microbiología, Hospital Universitario Ramón y Cajal, Ctra. de Colmenar, Km 9,1, 28034 Madrid, Spain
Received 19 February 2003; returned 20 March 2003; revised 31 March 2003; accepted 27 April 2003
The in vitro activities of telithromycin and cethromycin (ABT-773) against 412 Streptococcus pyogenes isolates, consecutively collected in 17 Spanish hospitals from different geographical areas, were evaluated and compared with those of erythromycin A, penicillin G, clindamycin and quinupristin–dalfopristin. With a susceptibility testing breakpoint of ≤1 mg/L for both compounds, 96.1% of isolates were susceptible to telithromycin and 99.8% to cethromycin. Erythromycin non-susceptible isolates (intermediate plus resistant, MIC ≥ 0.5 mg/L) comprised 23% of those tested, and were analysed for the genetic basis of their resistance by PCR. Among these isolates (n = 95), 72.6% harboured mef(A), 8.4%, erm(B), and 3.2%, erm(A), as sole macrolide resistance gene, whereas the presence of mef(A) plus erm(A) (11.6%) or mef(A) plus erm(B) (4.2%) was also observed. Both ketolides displayed a significant in vitro activity against S. pyogenes regardless of the macrolide resistance mechanisms. Nevertheless, in the case of telithromycin, 11 out of 19 of the erm(B)-positive isolates (2.7% of total population) exhibited an MIC range of 4–32 mg/L. According to the present results, telithromycin and cethromycin offer a wide coverage against S. pyogenes isolates in a geographic area with a high incidence of resistance to currently used macrolides.
Keywords: S. pyogenes, ketolides, telithromycin, cethromycin, macrolide resistance
* Corresponding author. Tel: +34-91-336-8330; Fax: +34-91-336-8809; E-mail: rcanton.hrc{at}salud.madrid.org
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