National Surveillance of Tetracycline, Erythromycin, and Clindamycin Resistance in Invasive <i>Streptococcus pyogenes</i>: A Retrospective Study of the Situation in Spain, 2007-2020

• Main Authors: Pilar Villalón (Author), Marta Bárcena (Author), María José Medina-Pascual (Author), Noelia Garrido (Author), Silvia Pino-Rosa (Author), Gema Carrasco (Author), Sylvia Valdezate (Author)
• Format: Book
• Published: MDPI AG, 2023-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

Background: This work reports on antimicrobial resistance data for invasive <i>Streptococcus pyogenes</i> in Spain, collected by the 'Surveillance Program for Invasive Group A <i>Streptococcus</i>', in 2007-2020. Methods: <i>emm</i> typing was determined by sequencing. Susceptibility to penicillin, tetracycline, erythromycin, and clindamycin was det<i>erm</i>ined via the E-test. <i>tet</i>M, <i>tet</i>O, <i>msr</i>D, <i>mef</i>A, <i>erm</i>B, <i>erm</i>TR, and <i>erm</i>T were sought by PCR. Macrolide-resistant phenotypes (M, cMLSB, and iMLSB) were detected using the erythromycin-clindamycin double-disk test. Resistant clones were identified via their <i>emm</i> type, multilocus sequence type (ST), resistance genotype, and macrolide resistance phenotype. Results: Penicillin susceptibility was universal. Tetracycline resistance was recorded for 237/1983 isolates (12.0%) (152 carried only <i>tet</i>M, 48 carried only <i>tet</i>O, and 33 carried both). Erythromycin resistance was detected in 172/1983 isolates (8.7%); <i>erm</i>B was present in 83, <i>mef</i>A in 58, <i>msr</i>D in 51, <i>erm</i>TR in 46, and <i>erm</i>T in 36. Clindamycin resistance (methylase-mediated) was present in 78/1983 isolates (3.9%). Eight main resistant clones were identified: two that were tetracycline-resistant only (<i>emm</i>22/ST46/<i>tet</i>M and <i>emm</i>77/ST63/<i>tet</i>O), three that were erythromycin-resistant only (<i>emm</i>4/ST39/<i>mef</i>A-<i>msr</i>D/M, <i>emm</i>12/ST36/<i>mef</i>A-<i>msr</i>D/M, and <i>emm</i>28/ST52/<i>erm</i>B/cMLSB), and three that were tetracycline-erythromycin co-resistant (<i>emm</i>11/ST403/<i>tet</i>M-<i>erm</i>B/cMLSB, <i>emm</i>77/ST63/<i>tet</i>O-<i>erm</i>TR/iMLSB, and <i>emm</i>77/ST63/<i>tet</i>M-<i>tet</i>O-<i>erm</i>TR/iMLSB). Conclusions: Tetracycline, erythromycin, and clindamycin resistance rates declined between 2007 and 2020. Temporal variations in the proportion of resistant clones det<i>erm</i>ined the change in resistance rates.

Item Description

10.3390/antibiotics12010099
2079-6382