Prevalence and molecular analysis of macrolide-resistant clinical isolates in Japan, following emergence of the highly macrolide-resistant strain NSH1 in 2011 Free

Abstract

Although is known to be susceptible to macrolides, highly macrolide-resistant isolates have recently been reported in Japan and China. In this study, we investigated the prevalence of macrolide-resistant isolates in Tokyo and Chiba, Japan, and studied the mechanisms underlying their resistance. Specifically, we determined the susceptibility of 593 clinical isolates (collected between December 2011 and May 2014) to erythromycin, using the disk diffusion method. For isolates with erythromycin resistance, we identified the MICs of seven antimicrobial agents, including macrolides, and used PFGE to analyse the clonal spread. We also performed sequencing analysis to investigate macrolide-resistance targets. Thirteen isolates (2.2 %) were found to be resistant to erythromycin, showing a high MIC to erythromycin, clarithromycin, clindamycin and azithromycin. However, those isolates, in addition to 156 randomly selected erythromycin-susceptible strains, were susceptible to amoxicillin–clavulanate, cefixime and levofloxacin. The 13 highly macrolide-resistant isolates were classified into 10 clades and harboured three or four A2058T-mutated 23S rRNA alleles. Three highly macrolide-resistant isolates also exhibited mutations in ribosomal proteins L4 (V27A and R161C) and L22 (K68T). To the best of our knowledge, we have demonstrated for the first time that, whilst the prevalence of macrolide-resistant isolates is low in clinical settings in Japan, genetically diverse isolates with high-level macrolide resistance due to the acquisition of an A2058T mutation in the 23S rRNA have already spread. Our study therefore lays the basis for epidemiological studies of macrolide-resistant clinical isolates.

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2015-07-01
2024-03-29
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References

  1. Chung W.O., Werckenthin C., Schwarz S., Roberts M.C. 1999; Host range of the ermF rRNA methylase gene in bacteria of human and animal origin. J Antimicrob Chemother 43:5–14 [View Article][PubMed]
    [Google Scholar]
  2. CLSI 2010 Methods for Antimicrobial Dilution and Disk Susceptibility Testing of Infrequently Isolated or Fastidious Bacteria Approved Standard M45-A2 Wayne, PA: Clinical and Laboratory Standards Institute;
    [Google Scholar]
  3. Farrell D.J., Flamm R.K., Jones R.N., Sader H.S. 2013; Spectrum and potency of ceftaroline tested against leading pathogens causing community-acquired respiratory tract infections in Europe (2010). Diagn Microbiol Infect Dis 75:86–88 [View Article][PubMed]
    [Google Scholar]
  4. Flamm R.K., Sader H.S., Farrell D.J., Jones R.N. 2012; Macrolide and tetracycline resistance among Moraxella catarrhalis isolates from 2009 to 2011. Diagn Microbiol Infect Dis. 74:198–200 [View Article][PubMed]
    [Google Scholar]
  5. Iwata S., Sato Y., Toyonaga Y., Hanaki H., Sunakawa K. 2015; Genetic analysis of a pediatric clinical isolate of Moraxella catarrhalis with resistance to macrolides and quinolones. J Infect Chemother 21:308–311 [View Article][PubMed]
    [Google Scholar]
  6. Lehtopolku M., Kotilainen P., Haanperä-Heikkinen M., Nakari U.M., Hänninen M.L., Huovinen P., Siitonen A., Eerola E., Jalava J., Hakanen A.J. 2011; Ribosomal mutations as the main cause of macrolide resistance in Campylobacter jejuni Campylobacter coli . Antimicrob Agents Chemother 55:5939–5941 [View Article][PubMed]
    [Google Scholar]
  7. Liu Y., Zhao C., Zhang F., Chen H., Chen M., Wang H. 2012; High prevalence and molecular analysis of macrolide-nonsusceptible Moraxella catarrhalis isolated from nasopharynx of healthy children in China. Microb Drug Resist 18:417–426 [View Article][PubMed]
    [Google Scholar]
  8. Marti S., Puig C., Domenech A., Liñares J., Ardanuy C. 2013; Comparison of restriction enzymes for pulsed-field gel electrophoresis typing of Moraxella catarrhalis . J Clin Microbiol 51:2448–2452 [View Article][PubMed]
    [Google Scholar]
  9. Murphy T.F., Parameswaran G.I. 2009; Moraxella catarrhalis, a human respiratory tract pathogen. Clin Infect Dis 49:124–131 [View Article][PubMed]
    [Google Scholar]
  10. Nakaminami H., Noguchi N., Ikeda M., Hasui M., Sato M., Yamamoto S., Yoshida T., Asano T., Senoue M., Sasatsu M. 2008; Molecular epidemiology and antimicrobial susceptibilities of 273 exfoliative toxin-encoding-gene-positive Staphylococcus aureus isolates from patients with impetigo in Japan. J Med Microbiol 57:1251–1258 [View Article][PubMed]
    [Google Scholar]
  11. Ng L.K., Martin I., Liu G., Bryden L. 2002; Mutation in 23S rRNA associated with macrolide resistance in Neisseria gonorrhoeae . Antimicrob Agents Chemother 46:3020–3025 [View Article][PubMed]
    [Google Scholar]
  12. Paukner S., Sader H.S., Ivezic-Schoenfeld Z., Jones R.N. 2013; Antimicrobial activity of the pleuromutilin antibiotic BC-3781 against bacterial pathogens isolated in the SENTRY antimicrobial surveillance program in 2010. Antimicrob Agents Chemother. 57:4489–4495 [View Article][PubMed]
    [Google Scholar]
  13. Roberts M.C. 2008; Update on macrolide-lincosamide-streptogramin, ketolide, and oxazolidinone resistance genes. FEMS Microbiol Lett 282:147–159 [View Article][PubMed]
    [Google Scholar]
  14. Saito R., Nonaka S., Nishiyama H., Okamura N. 2012; Molecular mechanism of macrolide-lincosamide resistance in Moraxella catarrhalis . J Med Microbiol 61:1435–1438 [View Article][PubMed]
    [Google Scholar]
  15. Saito R., Nonaka S., Fujinami Y., Matsuoka S., Nakajima S., Nishiyama H., Okamura N. 2014; The frequency of BRO β-lactamase and its relationship to antimicrobial susceptibility and serum resistance in Moraxella catarrhalis . J Infect Chemother 20:6–8 [View Article][PubMed]
    [Google Scholar]
  16. Sethi S., Murphy T.F. 2008; Infection in the pathogenesis and course of chronic obstructive pulmonary disease. N Engl J Med 359:2355–2365 [View Article][PubMed]
    [Google Scholar]
  17. Sutcliffe J., Grebe T., Tait-Kamradt A., Wondrack L. 1996; Detection of erythromycin-resistant determinants by PCR. Antimicrob Agents Chemother 40:2562–2566
    [Google Scholar]
  18. Vester B., Douthwaite S. 2001; Macrolide resistance conferred by base substitutions in 23S rRNA. Antimicrob Agents Chemother 45:1–12 [View Article][PubMed]
    [Google Scholar]
  19. Wang H., Chen M., Xu Y., Sun H., Yang Q., Hu Y., Cao B., Chu Y., Liu Y., other authors. 2011; Antimicrobial susceptibility of bacterial pathogens associated with community-acquired respiratory tract infections in Asia: report from the Community-Acquired Respiratory Tract Infection Pathogen Surveillance (CARTIPS) study, 2009-2010. Int J Antimicrob Agents 38:376–383 [View Article][PubMed]
    [Google Scholar]
  20. Watanabe A., Yanagihara K., Matsumoto T., Kohno S., Aoki N., Oguri T., Sato J., Muratani T., Yagisawa M., other authors. 2012; Nationwide surveillance of bacterial respiratory pathogens conducted by the Surveillance Committee of Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Clinical Microbiology in 2009: general view of the pathogens' antibacterial susceptibility. J Infect Chemother 18:609–620 [View Article][PubMed]
    [Google Scholar]
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