scholarly journals Prevalence of Polyclonal mefA-Containing Isolates among Erythromycin-Resistant Group A Streptococci in Southern Taiwan

2000 ◽  
Vol 38 (7) ◽  
pp. 2475-2479 ◽  
Author(s):  
Jing-Jou Yan ◽  
Hsiu-Mei Wu ◽  
Ah-Huei Huang ◽  
Hsiu-Mei Fu ◽  
Chen-Ting Lee ◽  
...  
Keyword(s):  
University Hospital ◽  
Group A Streptococci ◽  
Erythromycin Resistance ◽  
Drug Of Choice ◽  
High Incidence ◽  
Group A ◽  
Agar Dilution ◽  
Southern Taiwan ◽  
Resistant Group ◽  
Gene 4

A total of 204 nonrepetitive isolates of group A streptococci (GAS), including 107 randomly collected between 1992 and 1995 and 66 and 31 consecutively collected in 1997 and 1998, respectively, from a university hospital in southern Taiwan were examined to determine the prevalence and mechanisms of erythromycin resistance among these isolates. Resistance to erythromycin was detected in 129 isolates (63.2%) by the agar dilution test. Of these, 42 isolates (32.6%) were assigned to the constitutive macrolide, lincosamide, and streptogramin B resistance (cMLS) phenotype, and all carried the ermBgene; 4 (3.1%) were assigned to the inducible MLS resistance (iMLS) phenotype, and all harbored the ermTR gene; and 83 (64.3%) were erythromycin resistant but susceptible to clindamycin (M phenotype), and all possessed the mefA gene. Distributed by years, the rates of erythromycin resistance and different phenotypes were 61.7% (53.0% cMLS, 6.1% iMLS, and 40.9% M phenotype) between 1992 and 1995, 62.1% (12.2% cMLS and 87.8% M phenotype) in 1997, and 71.0% (9.1% cMLS and 90.9% M phenotype) in 1998. Pulsed-field gel electrophoresis showed that all but 2 cMLS isolates were clonal in origin, and 17 clones were detected among the M-phenotype isolates. These results indicate that the high incidence and increasing rate of erythromycin-resistant GAS in southern Taiwan are due to the prevalence of multiple M-phenotype clones and that clindamycin may be the drug of choice for the treatment of infections with GAS in penicillin-hypersensitive patients in this area.

Pharyngitis—Principles of Judicious Use of Antimicrobial Agents

PEDIATRICS ◽  
1998 ◽  
Vol 101 (Supplement_1) ◽  
pp. 171-174 ◽  
Author(s):  
Benjamin Schwartz ◽  
S. Michael Marcy ◽  
William R. Phillips ◽  
Michael A. Gerber ◽  
Scott F. Dowell
Keyword(s):  
Antimicrobial Agents ◽  
Low Cost ◽  
Streptococcal Pharyngitis ◽  
Clinical Findings ◽  
Group A Streptococci ◽  
Throat Culture ◽  
Drug Of Choice ◽  
Group A ◽  
Resistant Group ◽  
Test Result

Accurate diagnosis of group A streptococcal pharyngitis and appropriate antimicrobial therapy are important, particularly to prevent nonsuppurative sequelae such as rheumatic fever. Most episodes of sore throat, however, are caused by viral agents. Clinical findings cannot reliably differentiate streptococcal from viral pharyngitis and most physicians tend to overestimate the probability of a streptococcal infection based on history and physical examination alone. Therefore, diagnosis should be based on results of a throat culture or an antigen-detection test with throat culture backup. Presumptively starting therapy pending results of a culture is discouraged because treatment often continues despite a negative test result. Other bacterial causes of pharyngitis are uncommon and often can be diagnosed based on nonpharyngeal findings. Penicillin remains the drug of choice for streptococcal pharyngitis because of its effectiveness, relatively narrow spectrum, and low cost. No group A streptococci are resistant to β-lactam antibiotics. High rates of resistance to macrolides has been documented in several areas; in Finland, decreased national rates of macrolide use led to a decline in the proportion of macrolide-resistant group A streptococci.

Case 1

2020 ◽  
pp. 2-8
Author(s):  
Hilary Humphreys
Keyword(s):  
Prophylactic Antibiotics ◽  
Group A Streptococci ◽  
Drug Of Choice ◽  
Group A ◽  
Subcutaneous Tissues ◽  
Oral Switch ◽  
Healthcare Associated ◽  
Panton Valentine Leukocidin ◽  
Initial Drug ◽  
Valentine Leukocidin

Cellulitis is infection of the dermis and subcutaneous tissues unlike erysipelas which is more superficial and necrotizing fasciitis which involves deeper layers. Cellulitis is most commonly caused by Group A streptococci (GAS) and Staphylococcus aureus, including Panton–Valentine leukocidin-producing isolates. However, most cases are diagnosed clinically and the initial drug of choice is flucloxacillin. Five to ten days of treatment is usually adequate including an early intravenous to oral switch but prophylactic antibiotics may be considered for patients with two or more episodes to prevent further recurrence. There is poor evidence for the benefit of using adjuvant therapy, such as corticosteroids and intravenous immunoglobulin, in more severe cases. Healthcare-associated clusters or outbreaks may be associated with carriage of GAS in a staff member who should be treated if positive.

Persistence of Erythromycin-Resistant Group A Streptococci in Cultured Respiratory Cells

2006 ◽  
Vol 25 (10) ◽  
pp. 880-883 ◽  
Author(s):  
Cinzia Spinaci ◽  
Gloria Magi ◽  
Pietro E. Varaldo ◽  
Bruna Facinelli
Keyword(s):  
Group A Streptococci ◽  
Group A ◽  
Respiratory Cells ◽  
Resistant Group

scholarly journals A community outbreak of group A beta haemolytic streptococci with transferable resistance to erythromycin

1989 ◽  
Vol 102 (1) ◽  
pp. 85-91 ◽  
Author(s):  
R. J. D. Scott ◽  
J. Naidoo ◽  
N. F. Lightfoot ◽  
R. C. George
Keyword(s):  
Great Britain ◽  
Plasmid Dna ◽  
Recipient Strain ◽  
Group A Streptococci ◽  
Rare Occurrence ◽  
Erythromycin Resistance ◽  
Group A ◽  
The Town

SUMMARYErythromycin resistance amongst group A streptococci (GAS) in Great Britain is a relatively rare occurrence and outbreaks have been sporadically reported. Over an 8-month period in 1986 ten associated cases occurred in the town of Bridgwater in Somerset. Isolates were group A, type M4 and resistant to erythromycin (MIC 8 mg/l) but sensitive to lincomycin and clindamycin. Erythromycin resistance was transferable from all isolates to a group A recipient strain. No plasmid DNA could be detected in the original isolates or transconjugants.

scholarly journals The trend of macrolide resistance and emm types of group A streptococci from children at a medical center in southern Taiwan

2015 ◽  
Vol 48 (2) ◽  
pp. 160-167 ◽  
Author(s):  
Po-Kai Chuang ◽  
Shih-Min Wang ◽  
Hui-Chen Lin ◽  
Yu-Hao Cho ◽  
Yun-Ju Ma ◽  
...  
Keyword(s):  
Medical Center ◽  
Macrolide Resistance ◽  
Group A Streptococci ◽  
Group A ◽  
Southern Taiwan
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