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Syphilis Survey Reveals Need for Accurate Testing for Early Infection

November 1999

Volume 29, Number 5
Clinical Infectious Diseases 1999;29:1186–1188
© 1999 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/1999/2905-0012$03.00
DOI: 10.1086/313452

Prevalence of Macrolide Resistance Mechanisms in Streptococcus pneumoniae Isolates from a Multicenter Antibiotic Resistance Surveillance Study Conducted in the United States in 1994–1995

Virginia D. Shortridge,1

Gary V. Doern,2

Angela B. Brueggemann,2

Jill M. Beyer,1and

Robert K. Flamm1

From 1Infectious Diseases Microbiology, Abbott Laboratories, Abbott Park, Illinois; and 2Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa

Abstract

Two main mechanisms of macrolide resistance have been described in erythromycin‐resistant Streptococcus pneumoniae (ERSP): a ribosomal methylase, ErmAM, and a macrolide efflux pump, MefE. In this study, we examined the prevalence of these mechanisms in 114 clinical isolates of ERSP from a 30‐center study conducted in the United States between November 1994 and April 1995. The isolates were screened by polymerase chain reaction for the presence of known macrolide resistance genes. Seventy (61%) ERSP contained the macrolide efflux gene (mefE), whereas 36 isolates (32%) contained the biosomal methylase gene (ermAM). Isolates that were ermAM‐positive had constitutive macrolide resistance. The minimum inhibitory concentrations (for which 90% of isolates were susceptible) of clarithromycin for the efflux‐positive strains were much lower than those for the ermAM‐positive strains (4 μg/mL vs. >128 μg/mL, respectively). The efflux mechanism is the predominant form of macrolide resistance in the United States.

Received 2 February 1999; revised 18 June 1999.

Reprints or correspondence: Dr. Virginia D. Shortridge, Department 47T, Building AP52N, 200 Abbott Park Road, Abbott Park, IL 60064‐3537 ().

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