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Volume 6, Issue 6

Rising clindamycin resistance in group A Streptococcus in an Irish healthcare institution Open Access

Abstract

Group A streptococcus (GAS) can cause serious invasive disease in humans with a high mortality rate. An increase in GAS infections was reported in Ireland in 2022, and this increase has been sustained in 2023 and is paralleled by similar trends in Europe. Rising antimicrobial resistance is a global problem and presents significant challenges to clinicians treating GAS infection. There was a reported increase in clindamycin resistance in GAS isolates in Ireland in 2022. We examined antimicrobial susceptibility patterns of GAS isolates in our institution in 2022. Although all GAS isolates included in our study were susceptible to penicillin, we noted a high clindamycin resistance rate of 28 % in our invasive GAS isolates. We also noted high tetracycline and erythromycin resistance, 43 and 30 %, respectively. Our results could have implications for empiric antimicrobial prescribing guidelines for skin and soft tissue infections, which often include clindamycin as it inhibits the production of many virulence factors associated with GAS. In addition, macrolides are often the first line recommended antibiotic for patients with anaphylaxis to penicillin. This study emphasises the importance of continuous surveillance and antimicrobial susceptibility testing of invasive and non-invasive isolates in order to monitor trends in increasing antimicrobial resistance.

  • Received:
  • Accepted:
  • Published Online:
Keyword(s): clindamycin , group A Streptococcus and Streptococcus pyogenes: antimicrobial resistance
© 2024 The Authors
  • This is an open-access article distributed under the terms of the Creative Commons Attribution License. This article was made open access via a Publish and Read agreement between the Microbiology Society and the corresponding author’s institution.
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2024-06-27
2025-11-10

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References

  1. Brady D, Lapthorne S. Rising Clindamycin resistance in group A Streptococcus in an Irish Healthcare institution Figshare 2024 https://doi.org/10.6084/m9.figshare.25809451.v1
     [Google Scholar]
  2. Stevens DL. Invasive group A streptococcus infections. Clin Infect Dis 1992; 14:2–11 [View Article] [PubMed]
     [Google Scholar]
  3. Waddington CS, Snelling TL, Carapetis JR. Management of invasive group A streptococcal infections. J Infect 2014; 69:S63–S69 [View Article] [PubMed]
     [Google Scholar]
  4. HSE Health Protection Surveillance Centre Invasive Group A Streptococcal Disease in Ireland 2018. Dublin HSE HPSC; 2018
  5. Irish Meningitis and Sepsis Reference Laboratory Irish meningitis and sepsis reference laboratory report 2020 and 2021. Dublin: 2021
  6. HSE Health Protection Surveillance Centre Report on invasive group A streptococcal (iGAS) infections in Ireland. Dublin: 2024
  7. UK Health Security Agency Group A streptococcal infections: report on seasonal activity in England, 2022 to 2023. London: 2023
  8. World Health Organisation Increased incidence of scarlet fever and invasive group A Streptococcus infection - multi-country 2022; 2022 https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON429
  9. Bellés-Bellés A, Prim N, Mormeneo-Bayo S, Villalón-Panzano P, Valiente-Novillo M et al. Changes in group A Streptococcus emm types associated with invasive infections in adults, Spain, 2023. Emerg Infect Dis 2023; 29:2390–2392 [View Article] [PubMed]
     [Google Scholar]
  10. Smieja M. Current indications for the use of clindamycin: a critical review. Can J Infect Dis 1998; 9:22–28 [View Article] [PubMed]
     [Google Scholar]
  11. The European Committee on antimicrobial susceptibility testing Disk diffusion - manual v 10.0; 2022 https://www.eucast.org/ast_of_bacteria/previous_versions_of_documents
  12. The European Committee on antimicrobial susceptibility testing Breakpoint tables for interpretation of MICs and zone diameters, version 10.0; 2020 http://www.eucast.org/clinical_breakpoints
  13. Malhotra-Kumar S, Lammens C, Chapelle S, Wijdooghe M, Piessens J et al. Macrolide- and telithromycin-resistant Streptococcus pyogenes, Belgium, 1999-2003. Emerg Infect Dis 2005; 11:939–942 [View Article] [PubMed]
     [Google Scholar]
  14. Bae SY, Kim JS, Kwon J-A, Yoon S-Y, Lim CS et al. Phenotypes and genotypes of macrolide-resistant Streptococcus pyogenes isolated in Seoul, Korea. J Med Microbiol 2007; 56:229–235 [View Article] [PubMed]
     [Google Scholar]
  15. Villalón P, Sáez-Nieto JA, Rubio-López V, Medina-Pascual MJ, Garrido N et al. Invasive Streptococcus pyogenes disease in Spain: a microbiological and epidemiological study covering the period 2007-2019. Eur J Clin Microbiol Infect Dis 2021; 40:2295–2303 [View Article] [PubMed]
     [Google Scholar]
  16. Diep BA, Equils O, Huang DB, Gladue R. Linezolid effects on bacterial toxin production and host immune response: review of the evidence. Curr Ther Res Clin Exp 2012; 73:86–102 [View Article] [PubMed]
     [Google Scholar]
  17. Health Service Executive Antibiotic prescribing - conditions and treatments - pharyngitis / sore throat / tonsillitis Dublin. HSE; 2023 https://www.hse.ie/eng/services/list/2/gp/antibiotic-prescribing/conditions-and-treatments/upper-respiratory/pharyngitis-sore-throat-tonsillitis/pharyngitis-sore-throat-tonsillitis.html
  18. Health Service Executive Antibiotic prescribing - conditions and treatments - skin/soft tissue - cellulitis Dublin. HSE; 2023 https://www.hse.ie/eng/services/list/2/gp/antibiotic-prescribing/conditions-and-treatments/skin-soft-tissue/cellulitis/cellulitis.html
  19. HSE Health Protection Surveillance Centre Choice of agent for chemoprophylaxis for A contact of group A streptococcus case. Dublin: 2022
/content/journal/acmi/10.1099/acmi.0.000772.v4
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Rising clindamycin resistance in group A Streptococcus in an Irish healthcare institution
Access Microbiology 6, 000772.v4 (2024); https://doi.org/10.1099/acmi.0.000772.v4
/content/journal/acmi/10.1099/acmi.0.000772.v4
/content/journal/acmi/10.1099/acmi.0.000772.v4
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