1887

Abstract

To determine the prevalence of macrolide antibiotic and levofloxacin resistance in infections with (group A streptococcus or GAS), strains were collected from 45 medical institutions in various parts of Japan between October 2003 and September 2006. Four hundred and eighty-two strains from patients with GAS infections were characterized genetically. Strains were classified into four groups according to the type of infection: invasive infections (=74) including sepsis, cellulitis and toxic-shock-like syndrome; acute otitis media (AOM; =23); abscess (=53); and pharyngotonsillitis (=332). Among all strains, 32 types were identified; was significantly more common in invasive infections (39.2 %) and AOM (43.5 %) than in abscesses (3.8 %) or pharyngotonsillitis (10.2 %). and each accounted for 23.5 % of pharyngotonsillitis cases. Susceptibility of GAS strains to eight -lactam agents was excellent, with MICs of 0.0005–0.063 μg ml. Macrolide-resistant strains accounted for 16.2 % of all strains, while the percentages of strains possessing the resistance genes (A), (B) and (A) were 2.5 %, 6.2 % and 7.5 %, respectively. Although no strains with high resistance to levofloxacin were found, strains with an MIC of 2–4 μg ml (17.4 %) had amino acid substitutions at either Ser-79 or Asp-83 in ParC. These levofloxacin-intermediately resistant strains included 16 types, but macrolide-resistant strains were more likely than others to represent certain types.

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2008-11-01
2021-02-28
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