JAC Advance Access published online on December 12, 2002
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkg039
© 2002 by The British Society for Antimicrobial Chemotherapy
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Original Paper
1 Department of Internal
Medicine I, Division of Infectious Diseases and Chemotherapy, University of Vienna, Vienna General
Hospital, Waehringer Guertel 18-20, 1090 Vienna, Austria
* Corresponding author. E-mail: apostolos.georgopoulos{at}akh-wien.ac.at.
Received 7 August 2002
; revised 21 August 2002
; accepted 8 October 2002
The purpose of the present study was to determine the
antimicrobial resistance among Streptococcus pyogenes in
Bavaria, Germany. Five hundred and forty isolates of S.
pyogenes were collected from patients with tonsillopharyngitis.
Of these, 425 isolates were obtained from children and 115 from
adult patients. All isolates were tested for susceptibility to macrolides, clindamycin,
penicillin and 10 other commonly prescribed antimicrobial agents,
using broth microdilution tests. All isolates were fully susceptible
to penicillin, amoxicillin and cephalosporins; 16.1% of
the isolates were resistant to tetracycline. MIC90 values
of erythromycin, clarithromycin, azithromycin and josamycin were
16, 4, 16 and 0.5 mg/L. The overall resistance rate of S.
pyogenes to erythromycin, clarithromycin and azithromycin was
13.3%. All isolates resistant to erythromycin were also
resistant to clarithromycin and azithromycin, and vice versa. Erythromycin
resistance rates were higher in adult patients (19.1%)
than in children (11.8%). The resistance rate to josamycin
was only 1.5%, a value similar to that of clindamycin (1.1%).
Among the 72 erythromycin-resistant isolates the M phenotype of
macrolide resistance predominated (78%), while percentages
of cMLSB (8%) and iMLSB (14%)
phenotypes were low. Of the iMLSB strains (n = 10),
the majority were of the subtype C (n = 8).
The M phenotype was associated with a low, and the iMLSB-C
phenotype with a high, rate of resistance to tetracycline. Conclusively, present
data point to rising macrolide resistance among S. pyogenes in
Bavaria.
Keywords: S. pyogenes, Bavaria, susceptibility,
macrolide resistance, phenotypes
Phenotypes of macrolide resistance of group A streptococci
isolated from outpatients in Bavaria and susceptibility to 16 antibiotics
2 Department of Internal Medicine
IV, Division of Pulmology, University of Vienna, Vienna General
Hospital, Waehringer Guertel 18-20, 1090 Vienna, Austria
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