JAC Advance Access published online on January 16, 2004
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkh026
© 2004 by The British Society for Antimicrobial Chemotherapy
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Original article
1 Department of Medical
Microbiology, University of Antwerp, S3, Universiteitsplein 1, B-2610
Wilrijk, Antwerp;
* Corresponding author. E-mail: surbhi.malhotra{at}ua.ac.be.
Received 31 July 2003
; revised 8 October 2003
; accepted 16 October 2003
Objectives: Viridans group streptococci
(VGS) are gaining significance as reservoirs of resistance determinants
for respiratory tract pathogens. Our aim was to investigate healthy
adults for oropharyngeal carriage of VGS that are resistant to macrolides,
as well as to other common antibiotics. Methods: Macrolide-resistant VGS were isolated
from throat samples of 154 healthy Belgian adults, and phenotyped
and genotyped for erm(A), erm(B)
and mef(A). In vitro susceptibilities
to 10 antimicrobials and the presence of tetracycline resistance
genes were also determined. Results: Carriage was detected in 71% of
the population screened, from whom 157 unique, macrolide-resistant VGS
were isolated. A constitutive (cMLS) phenotype was present in 105
isolates, of which 102 isolates carried either erm(B)
or erm(B) + mef(A). The
remaining three isolates did not present with any of the genes studied.
All 45 isolates showing the M phenotype carried mef(A).
The least abundant inducible (iMLS) isolates (n = 7)
carried either erm(B) or erm(B) + mef(A). The most abundant macrolide-resistant VGS
species was Streptococcus mitis (51%).
Co-resistance to tetracycline was identified in 114 isolates, of
which tet(M) was present in 105, tet(O)
in two and both tet(M) and tet(O)
in one, while the remaining six isolates did not present with either
gene. tet(M) was also present in four tetracycline
susceptible and two intermediately resistant isolates. Fluoroquinolone
resistance (ciprofloxacin MIC Conclusions: This study highlights a high oropharyngeal
carriage of macrolide-resistant VGS and its co-resistance
to tetracycline and fluoroquinolones among healthy Belgian adults.
Keywords: oral flora, commensals, tetracycline
Oropharyngeal carriage of macrolide-resistant viridans
group streptococci: a prevalence study among healthy adults in Belgium
2 Department
of Pathology, Bacteriology and Poultry Diseases, Faculty of Veterinary
Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
4 mg/L)
was detected in 16 isolates. Resistance to telithromycin, penicillin
and chloramphenicol was appreciably low.
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