TITLE

Streptococcus Pneumoniae'da Makrolid Direnç Mekanizmalari ile Serotip İlişkisi

AUTHOR(S)
TiryakioĞlu, Nebahat; Aksu, Burak; Hasdemir, Ufuk Över
PUB. DATE
September 2012
SOURCE
Journal of Marmara University Institute of Health Sciences;Sep2012, Vol. 2 Issue 3, p124
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Increased resistance rate to macrolides used as empirical treatment of pneumococcal infections is a major problem in our country and all over the world. In our study, we aimed to determine macrolide resistance mechanisms of the erythromycin-resistant Streptococcus pneumonia isolated from clinical samples and to investigate serotype and resistance relationship within our region with the high macrolide resistance rates among pneumococci. Fifty isolates were studied for erythromycin, azithromycin, clarithromycin, clindamycin susceptibilities with disk diffusion, and liquid microdilution methods. Genetic determinants of macrolide resistance, mef(A), mef(E), erm(B), erm(TR) genes were investigated by PCR using specific primers for each gene, multiplex PCR was used to determine the serotypes. Constitutive and inducible MLSB phenotypes and M phenotype were expressed in 86%, 4% and 10% of the isolates, respectively. Total of 42% of the isolates (n=21) were positive for erm(B), 12% (n=6) for mef(E) gene, in 46% (n=23) of the isolates both genes were detected. Serotype distribution was as follows: 28 (56%) 19F, 6 (12%) 6A/B, 5 (10%) 23F, 1 (2%) 39, 2 (4%) 15A-F, 1 (2%) 14, 1 (% 2) 23B and 6 (%12) isolates were nontypeable. 12 isolates carry erm(B), and 16 isolates carry both erm(B) and mef(E) in serotype 19F. One isolate carries erm(B), and 5 isolates carry both erm(B) and mef(E) in serotype 6A/B. Four isolates carry erm(B) and one isolate carries both erm(B) and mef(E) in serotype 23F. The most striking results of this study are the presence of macrolide efflux pump coding mef(E) gene in 58% of our isolates, the presence of additional erm(B) gene in %46 of isolates, and high rate of erm(B)+ mef(E) genes combination (56%) in predominant serotype 19F isolates.
ACCESSION #
82560428

 

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