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JAC Advance Access published online on August 25, 2004

Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkh420
© 2004 by The British Society for Antimicrobial Chemotherapy
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Received May 20, 2004
Revised July 20, 2004
Accepted August 4, 2004

Brief report

A rapid increase in macrolide resistance in Streptococcus pyogenes isolated in Poland during 1996-2002

Katarzyna Szczypa 1*, Ewa Sadowy 2, Radoslaw Izdebski 2, Waleria Hryniewicz 3

1 Department of Epidemiology and Clinical Microbiology,, National Institute of Public Health, Chelmska str 30/34, 00-725 Warsaw, Poland and
2 Department of Molecular Microbiology, National Institute of Public Health, Chelmska str 30/34, 00-725 Warsaw, Poland
3 Department of Epidemiology and Clinical Microbiology,, National Institute of Public Health, Chelmska str 30/34, 00-725 Warsaw, Poland and Department of Molecular Microbiology, National Institute of Public Health, Chelmska str 30/34, 00-725 Warsaw, Poland

* To whom correspondence should be addressed. E-mail: kazbunda{at}cls.edu.pl.


   Abstract

Objectives: The aim of this study was to investigate Polish clinical isolates of Streptococcus pyogenes collected during a 7 year period using phenotypic and genotypic techniques.

Methods: A total of 816 isolates of S. pyogenes recovered from 33 medical centres in Poland were tested for their susceptibility to various antimicrobial agents. Erythromycin-resistant isolates were analysed by PFGE, multilocus sequence typing and emm typing methods.

Results: The tetracycline resistance rate was high (43%) among all S. pyogenes strains. Ninety-eight (12%) isolates were resistant to erythromycin. A low prevalence of the M phenotype (5.1%) associated with the presence of the mef(A) gene was found. All the isolates of the iMLSB phenotype harboured the erm(TR) gene. Out of the cMLSB isolates, 71.4% and 28.6% carried erm(TR) and erm(B), respectively. All isolates with erm(B) were resistant to telithromycin. PFGE analysis discerned 13 different patterns, A-N, with two predominant PFGE profiles--A (41 isolates) and B (25 isolates)--that in multilocus sequence typing corresponded, respectively, to a novel sequence type (ST) 367 and ST63. Overall, the representatives of these clones accounted for >90% of isolates of the iMLSB phenotype.

Conclusions: A significant increase in erythromycin resistance was observed among clinical S. pyogenes collected in Poland over a 7 year period driven by the spread of two epidemic clones.

Keywords: S. pyogenes; erythromycin resistance; phenotypes; genotypes.
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