1887

Abstract

We evaluated temporal fluctuations in macrolide resistance rates, analysing genetic determinants of resistance and clonal evolution in a population of 2744 isolates collected in the period 2000–2013. The total resistance rate to erythromycin of the isolates was 17.9 %. A maximum of erythromycin resistance emerged in 2000 (38.6 %), followed by a significant decrease to 5.2 % in 2012 ( < 0.0001). Molecular analysis revealed the presence and co-presence of known genetic resistance determinants , , and , in line with phenotypes. PFGE analysis identified genetically related groups in 2000 and 2007–2008, mainly the MLS and M phenotypes, respectively. The most prevalent types among a representative subset of resistant isolates were , and . All and 88.2 % of the strains harbouring the gene were only recorded in M-phenotype strains, whilst all -positive strains had the inducible MLS phenotype. The analysed susceptible isolates showed several types partially shared with resistant ones. Our results suggest that changes in bacterial population clonality, rather than horizontal transfer of resistance determinants, plays a major epidemiological role in . Continuous monitoring of microbiological epidemiology seems to be crucial for correct and effective management of streptococcal infections.

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2015-10-01
2019-10-19
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