Genetic commonality of macrolide-resistant group A beta hemolytic streptococcus pharyngeal strains
Group A beta hemolytic streptococcus (GABHS) pharyngitis is a common childhood illness. Penicillin remains the gold standard therapy, but macrolides are indicated for the penicillin allergic patient, and are often used for convenience.
Methods: We conducted a surveillance study of children with pharyngitis and positive streptococcal rapid antigen testing from 10/05 to 10/06 at 2 sites (A &B).
Demographics, treatment, and resistance data was collected and compared to previous data from 2002. Erythromycin (EM) resistance was determined by disk diffusion and E-test on 500 isolates.
Pulse field gel electrophoresis (PFGE) was performed to measure genetic relatedness of isolates. StatXact version 8 software (Cytel Inc ., Cambridge, MA) was utilized to perform Fisher's exact test and exact confidence interval (CI) analysis.
Results: There were no differences in resistance rates or demographic features, with the exception of race, between sites A &B.
EM resistance was 0 in 2002, 3.5% in 2005-06 at site A, and 4.5% in 2005-06 at site B. 3/7 and 3/9 had inducible resistance at A and B respectively.
8 isolates had relatedness greater than or equal to 80%, 5 of which were 88% homologous on PFGE.
Conclusion: Community macrolide resistance has increased following increased macrolide use. These results may have treatment implications if use continues to be high.
Author: Angela MyersMary Anne JacksonRangaraj SelvaranganRichard GoeringChristopher Harrison
Credits/Source: Annals of Clinical Microbiology and Antimicrobials 2009, 8:33
Published on: 2009-12-01
Copyright by the authors listed above - made available via BioMedCentral (Open Access). Please
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