1887

Abstract

Group B streptococcus (GBS) is a commensal bacterium of the human gastrointestinal and genital tracts. It is a leading cause of neonatal sepsis and meningitis, and has also been recognized as an important pathogen in pregnant women and the elderly. We investigated mechanisms of macrolide and tetracycline resistance in GBS colonizing women in Egypt. A total of 100 isolates were screened using standard antibiotic susceptibility tests. A multiplex PCR assay was used to detect macrolide- and tetracycline-resistance determinants. All isolates were uniformly susceptible to penicillin G, ampicillin, cefotaxime, vancomycin and levofloxacin. The resistance rates to erythromycin, clindamycin, azithromycin, tetracycline and chloramphenicol were 17, 14, 16, 98 and 1 %, respectively. Among the erythromycin-resistant isolates, 82.4 % had constitutive macrolide–lincosamide–streptogramin B (cMLS) resistance, 5.9 % had inducible MLS (iMLS) resistance and 11.8 % had M phenotype resistance. Among the cMLS phenotypes, 64.3 % of isolates harboured the gene and 35.7 % of isolates harboured none of the investigated macrolide-resistance genes. The single strain expressing the iMLS phenotype possessed the gene. Of the two strains with the M phenotype, only one possessed the gene. Conversely, seven macrolide-sensitive strains (MIC <0.03 µg ml) were positive and one macrolide-sensitive strain (MIC <0.03 µg ml) harboured . Tetracycline resistance was predominantly due to , which was detected alone (83.7 %) or in association with (12.2 %), (1 %) or (1 %). One strain carried associated with both and , and another strain carried alone. The strains were positive for the gene, and the and carrier strains harboured the gene. Susceptible strains harbouring but not expressing an antibiotic-resistance gene should be regarded as potentially resistant. These results emphasize the need to monitor the epidemiology of GBS antibiotic resistance in Egypt.

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2014-10-01
2019-11-20
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References

  1. Acikgoz Z. C., Almayanlar E., Gamberzade S., Gocer S.. ( 2004;). Macrolide resistance determinants of invasive and noninvasive group B streptococci in a Turkish hospital. . Antimicrob Agents Chemother 48:, 1410–1412. [CrossRef][PubMed]
    [Google Scholar]
  2. Arpin C., Daube H., Tessier F., Quentin C.. ( 1999;). Presence of mefA and mefE genes in Streptococcus agalactiae. . Antimicrob Agents Chemother 43:, 944–946.[PubMed]
    [Google Scholar]
  3. Boswihi S. S., Udo E. E., Al-Sweih N.. ( 2012;). Serotypes and antibiotic resistance in group B streptococcus isolated from patients at the Maternity Hospital, Kuwait. . J Med Microbiol 61:, 126–131. [CrossRef][PubMed]
    [Google Scholar]
  4. Brzychczy-Wloch M., Gosiewski T., Bodaszewska M., Pabian W., Bulanda M., Kochan P., Strus M., Heczko P. B.. ( 2010;). Genetic characterization and diversity of Streptococcus agalactiae isolates with macrolide resistance. . J Med Microbiol 59:, 780–786. [CrossRef][PubMed]
    [Google Scholar]
  5. Chopra I., Roberts M.. ( 2001;). Tetracycline antibiotics: mode of action, applications, molecular biology, and epidemiology of bacterial resistance. . Microbiol Mol Biol Rev 65:, 232–260. [CrossRef][PubMed]
    [Google Scholar]
  6. Chopra I., Hawkey P. M., Hinton M.. ( 1992;). Tetracyclines, molecular and clinical aspects. . J Antimicrob Chemother 29:, 245–277. [CrossRef][PubMed]
    [Google Scholar]
  7. CLSI ( 2006a;). Performance Standards for Antimicrobial Disk Susceptibility Tests; Approved Standard, , 9th edn., M2-A9. Wayne, PA:: Clinical and Laboratory Standards Institute;.
    [Google Scholar]
  8. CLSI ( 2006b;). Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically; Approved Standard, , 7th edn., M7-A7. Wayne, PA:: Clinical and Laboratory Standards Institute;.
    [Google Scholar]
  9. CLSI ( 2007;). Performance Standards for Antimicrobial Susceptibility Testing; 17th Informational Supplement M100-S17. Wayne, PA:: Clinical and Laboratory Standards Institute;.
    [Google Scholar]
  10. De Mouy D., Cavallo J. D., Leclercq R., Fabre R..AFICORPI-BIO Network. Association de Formation Continue en Pathologie Infectieuse des Biologistes ( 2001;). Antibiotic susceptibility and mechanisms of erythromycin resistance in clinical isolates of Streptococcus agalactiae: French multicenter study. . Antimicrob Agents Chemother 45:, 2400–2402. [CrossRef][PubMed]
    [Google Scholar]
  11. Diner E. J., Hayes C. S.. ( 2009;). Recombineering reveals a diverse collection of ribosomal proteins L4 and L22 that confer resistance to macrolide antibiotics. . J Mol Biol 386:, 300–315. [CrossRef][PubMed]
    [Google Scholar]
  12. Figueira-Coelho J., Ramirez M., Salgado M. J., Melo-Cristino J.. ( 2004;). Streptococcus agalactiae in a large Portuguese teaching hospital: antimicrobial susceptibility, serotype distribution, and clonal analysis of macrolide-resistant isolates. . Microb Drug Resist 10:, 31–36. [CrossRef][PubMed]
    [Google Scholar]
  13. Fitoussi F., Loukil C., Gros I., Clermont O., Mariani P., Bonacorsi S., Le Thomas I., Deforche D., Bingen E.. ( 2001;). Mechanisms of macrolide resistance in clinical group B streptococci isolated in France. . Antimicrob Agents Chemother 45:, 1889–1891. [CrossRef][PubMed]
    [Google Scholar]
  14. Florindo C., Viegas S., Paulino A., Rodrigues E., Gomes J. P., Borrego M. J.. ( 2010;). Molecular characterization and antimicrobial susceptibility profiles in Streptococcus agalactiae colonizing strains: association of erythromycin resistance with subtype III-1 genetic clone family. . Clin Microbiol Infect 16:, 1458–1463. [CrossRef][PubMed]
    [Google Scholar]
  15. Hraoui M., Boutiba-Ben Boubaker I., Rachdi M., Slim A., Ben Redjeb S.. ( 2012;). Macrolide and tetracycline resistance in clinical strains of Streptococcus agalactiae isolated in Tunisia. . J Med Microbiol 61:, 1109–1113. [CrossRef][PubMed]
    [Google Scholar]
  16. Leclercq R.. ( 2002;). Mechanisms of resistance to macrolides and lincosamides: nature of the resistance elements and their clinical implications. . Clin Infect Dis 34:, 482–492. [CrossRef][PubMed]
    [Google Scholar]
  17. Malhotra-Kumar S., Lammens C., Piessens J., Goossens H.. ( 2005;). Multiplex PCR for simultaneous detection of macrolide and tetracycline resistance determinants in streptococci. . Antimicrob Agents Chemother 49:, 4798–4800. [CrossRef][PubMed]
    [Google Scholar]
  18. Martineau F., Picard F. J., Lansac N., Ménard C., Roy P. H., Ouellette M., Bergeron M. G.. ( 2000;). Correlation between the resistance genotype determined by multiplex PCR assays and the antibiotic susceptibility patterns of Staphylococcus aureus and Staphylococcus epidermidis. . Antimicrob Agents Chemother 44:, 231–238. [CrossRef][PubMed]
    [Google Scholar]
  19. Phares C. R., Lynfield R., Farley M. M., Mohle-Boetani J., Harrison L. H., Petit S., Craig A. S., Schaffner W., Zansky S. M.. & other authors ( 2008;). Epidemiology of invasive group B streptococcal disease in the United States, 1999–2005. . JAMA 299:, 2056–2065. [CrossRef][PubMed]
    [Google Scholar]
  20. Roberts M. C.. ( 1996;). Tetracycline resistance determinants: mechanisms of action, regulation of expression, genetic mobility, and distribution. . FEMS Microbiol Rev 19:, 1–24. [CrossRef][PubMed]
    [Google Scholar]
  21. Sadowy E., Matynia B., Hryniewicz W.. ( 2010;). Population structure, virulence factors and resistance determinants of invasive, non-invasive and colonizing Streptococcus agalactiae in Poland. . J Antimicrob Chemother 65:, 1907–1914. [CrossRef][PubMed]
    [Google Scholar]
  22. Shabayek S., Abdalla S., Abouzeid A. M.. ( 2014;). Serotype and surface protein gene distribution of colonizing group B streptococcus in women in Egypt. . Epidemiol Infect 142:, 208–210.[PubMed]
    [Google Scholar]
  23. Tazi A., Morand P. C., Réglier-Poupet H., Dmytruk N., Billoët A., Antona D., Trieu-Cuot P., Poyart C.. ( 2011;). Invasive group B streptococcal infections in adults, France (2007–2010). . Clin Microbiol Infect 17:, 1587–1589. [CrossRef][PubMed]
    [Google Scholar]
  24. Verani J. R., McGee L., Schrag S. J..Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC) ( 2010;). Prevention of perinatal group B streptococcal disease—revised guidelines from CDC, 2010. . MMWR Recomm Rep 59: (RR-10), 1–36.[PubMed]
    [Google Scholar]
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