caa a22 4500 606155775 CHVBK 20210128100605.0 cr unu---uuuuu 210128e20150901xx s 000 0 eng 10.1007/s10096-015-2414-x doi (NATIONALLICENCE)springer-10.1007/s10096-015-2414-x Decline in macrolide resistance rates among Streptococcus pyogenes causing pharyngitis in children isolated in Italy [Elektronische Daten] [G. Gherardi, D. Petrelli, M. Di Luca, F. Pimentel de Araujo, P. Bernaschi, A. Repetto, J. Bellesi, L. Vitali] Macrolides are often used to treat group A streptococcus (GAS) infections, but their resistance rates reached high proportions worldwide. The aim of the present study was to give an update on the characteristics and contemporary prevalence of macrolide-resistant pharyngeal GAS in Central Italy. A total of 592 isolates causing pharyngitis in children were collected in the period 2012-2013. Clonality was assessed by emm typing and pulsed-field gel electrophoresis (PFGE) for all macrolide-resistant strains and for selected susceptible isolates. Genetic determinants of resistance were screened by polymerase chain reaction (PCR). Forty-four GAS were erythromycin-resistant (7.4%). Among them, 52.3% and 50% were clindamycin- and tetracycline-resistant, respectively. erm(B)-positive isolates (52.3%) expressed the constitutive cMLSB phenotype. mef(A) and its associated M phenotype were recorded in 40.9% of the cases. The remaining erm(A)-positive isolates expressed the iMLSB phenotype. Seventeen tetracycline-resistant isolates carried tet(M) and five isolates carried tet(O). Twenty-five emm types were found among all strains, with the predominance of emm types 12, 89, 1, and 4. Eleven emm types and 12 PFGE clusters characterized macrolide-resistant strains, with almost two-thirds belonging to emm12, emm4, and emm11. Macrolide-susceptible and -resistant emm types 12, 89, 11, and 4 shared related PFGE profiles. There was a dramatic decline in macrolide resistance in Central Italy among pharyngeal GAS isolates in 2012-2013 when compared to previous studies from the same region (p < 0.05), although macrolide consumption remained stable over the past 15years. We observed a decrease in the proportion of macrolide-resistant strains within emm types commonly associated with macrolide resistance in the past, namely emm12, 1, and 89. The Author(s), 2015 Gherardi G. University Campus Bio-Medico, 00128, Roma, Italy aut Petrelli D. School of Biosciences and Veterinary Medicine, University of Camerino, 62032, Camerino, MC, Italy aut Di Luca M. School of Biosciences and Veterinary Medicine, University of Camerino, 62032, Camerino, MC, Italy aut Pimentel de Araujo F. University Campus Bio-Medico, 00128, Roma, Italy aut Bernaschi P. Unit of Microbiology, Bambino Gesù Children's Hospital, Roma, Italy aut Repetto A. Azienda Ospedaliera di Perugia, Struttura Complessa di Microbiologia, Santa Maria della Misericordia Hospital Perugia, Perugia, Italy aut Bellesi J. Azienda Ospedaliera di Macerata, Macerata, Italy aut Vitali L. School of Pharmacy, Microbiology Unit, University of Camerino, via Gentile III da Varano, 62032, Camerino, MC, Italy aut European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/9(2015-09-01), 1797-1802 0934-9723 34:9<1797 2015 34 10096 https://doi.org/10.1007/s10096-015-2414-x text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10096-015-2414-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Gherardi G. University Campus Bio-Medico, 00128, Roma, Italy aut NATIONALLICENCE 700 1- Petrelli D. School of Biosciences and Veterinary Medicine, University of Camerino, 62032, Camerino, MC, Italy aut NATIONALLICENCE 700 1- Di Luca M. School of Biosciences and Veterinary Medicine, University of Camerino, 62032, Camerino, MC, Italy aut NATIONALLICENCE 700 1- Pimentel de Araujo F. University Campus Bio-Medico, 00128, Roma, Italy aut NATIONALLICENCE 700 1- Bernaschi P. Unit of Microbiology, Bambino Gesù Children's Hospital, Roma, Italy aut NATIONALLICENCE 700 1- Repetto A. Azienda Ospedaliera di Perugia, Struttura Complessa di Microbiologia, Santa Maria della Misericordia Hospital Perugia, Perugia, Italy aut NATIONALLICENCE 700 1- Bellesi J. Azienda Ospedaliera di Macerata, Macerata, Italy aut NATIONALLICENCE 700 1- Vitali L. School of Pharmacy, Microbiology Unit, University of Camerino, via Gentile III da Varano, 62032, Camerino, MC, Italy aut NATIONALLICENCE 773 0- European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/9(2015-09-01), 1797-1802 0934-9723 34:9<1797 2015 34 10096