Journal Article

Prevalence of Macrolide Resistance Mechanisms in <i>Streptococcus pneumoniae</i> Isolates from a Multicenter Antibiotic Resistance Surveillance Study Conducted in the United States in 1994–1995

Virginia D. Shortridge, Gary V. Doern, Angela B. Brueggemann, Jill M. Beyer and Robert K. Flamm

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 29, issue 5, pages 1186-1188
Published in print November 1999 | ISSN: 1058-4838
Published online November 1999 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/313452
Prevalence of Macrolide Resistance Mechanisms in Streptococcus pneumoniae Isolates from a Multicenter Antibiotic Resistance Surveillance Study Conducted in the United States in 1994–1995

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Two main mechanisms of macrolide resistance have been described in erythromycin-resistant Streptococcus pneumoniae (ERSP): a ribosomal methylase, ErmAM, and a macrolide efflux pump, MefE. In this study, we examined the prevalence of these mechanisms in 114 clinical isolates of ERSP from a 30-center study conducted in the United States between November 1994 and April 1995. The isolates were screened by polymerase chain reaction for the presence of known macrolide resistance genes. Seventy (61%) ERSP contained the macrolide efflux gene (mefE), whereas 36 isolates (32%) contained the biosomal methylase gene (ermAM). Isolates that were ermAM-positive had constitutive macrolide resistance. The minimum inhibitory concentrations (for which 90% of isolates were susceptible) of clarithromycin for the efflux-positive strains were much lower than those for the ermAM-positive strains (4 μg/mL vs. >128 μg/mL, respectively). The efflux mechanism is the predominant form of macrolide resistance in the United States.

Journal Article.  1950 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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