ABSTRACTThein vitroantibacterial activity of solithromycin (CEM-101) against macrolide-resistant isolates (n= 62) ofStreptococcus agalactiae(group B streptococcus [GBS]) was determined. Phenotypic characterization of macrolide-resistant strains was performed by double-disc diffusion testing. A multiplex PCR was used to identify theerm(B),erm(TR), andmef(A/E) genes, capsular genotypes, and alpha-like (Alp) protein genes from the GBS strains. Determination of MIC was carried out using the microdilution broth method. The Etest method was used for penicillin, azithromycin, clarithromycin, and erythromycin. Solithromycin had a MIC50of ≤0.008 μg/ml and a MIC90of 0.015 μg/ml against macrolide-susceptibleS. agalactiae. These MICs were lower than those displayed by penicillin (MIC50of 0.032 μg/ml and MIC90of 0.047 μg/ml), the antibiotic agent of choice for prophylaxis and treatment of GBS infections. Against macrolide-resistantS. agalactiae, solithromycin had a MIC50of 0.03 μg/ml and a MIC90of 0.125 μg/ml. Againsterm(B) strains, solithromycin had a MIC50of 0.03 μg/ml and a MIC90of 0.06 μg/ml, while againstmef(A) strains, it had a MIC50of 0.03 μg/ml and a MIC90of 0.125 μg/ml. Most erythromycin-resistant GBS strains were of serotype V (64.5%) and associated significantly withalp2-3. Moreover, a statistically significant association was observed between the constitutive macrolide-lincosamide-streptogramin B resistance (cMLSB) phenotype and theerm(B) gene-carrying strains, thealp2-3gene and the M phenotype, and themef(A/E) gene andepsilon. Overall, our results show that solithromycin had lower or similar MICs than penicillin and potent activity against macrolide-resistant strains independent of their genotype or phenotype, representing a valid therapeutic alternative where β-lactams cannot be used.
Molecular and phenotypic characterization of invasive group B streptococcus strains from infants in Norway 2006–2007
