Community-based surveillance in the United States of macrolide-resistant pediatric pharyngeal group A streptococci during 3 respiratory disease seasons

Robert R Tanz*, Stanford T Shulman, Virginia D. Shortridge, William Kabat, Kathy Kabat, Emily Cederlund, Jason Rippe, Jill Beyer, Stella Doktor, Bernard W. Beall

*Corresponding author for this work

Research output: Contribution to journalArticle

53 Citations (Scopus)

Abstract

Background. In 2001, a total of 48% of pharyngeal group A streptococci (GAS) from Pittsburgh children were macrolide resistant. We assessed macrolide resistance, resistance genes, and emm types among GAS in the United States. Methods. In prospective, multicenter, community-based surveillance of pharyngeal GAS recovered from children 3-18 years old during 3 respiratory seasons (the 2000-2001 season, the 2001-2002 season, and the 2002-2003 season), GAS were tested for macrolide resistance and underwent emm gene sequencing. Macrolide-resistant GAS were tested for resistance to clindamycin, and resistance genes were determined. Results. Erythromycin resistance was observed in 4.4% of isolates from the 2000-2001 season, 4.3% from the 2001-2002 season, and 3.8% from the 2002-2003 season (P = .80). Clindamycin resistance was found in 1.04% of isolates; annual rates of clindamycin resistance were stable (P = .75). The predominant resistance genotype each year was mef A (65%-76.9%; overall, 70.3%). Resistant isolates included strains representing 8-11 different emm types each year. Heterogeneity of emm subtypes, resistance genes, and clindamycin resistance was evident among resistant isolates within some emm types. Geographic variability in resistance rates was present each year. Conclusions. The macrolide resistance rate among pharyngeal GAS was <5% and was stable over the 3 seasons. However, rates varied among sites each year. There was no evidence of spread of a specific resistant clone, increasing clindamycin resistance, or escalation in median erythromycin MICs.

Original languageEnglish (US)
Pages (from-to)1794-1801
Number of pages8
JournalClinical Infectious Diseases
Volume39
Issue number12
DOIs
StatePublished - Dec 15 2004

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Macrolides
Streptococcus
Clindamycin
Pediatrics
Erythromycin
Genes
Clone Cells
Genotype

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Tanz, Robert R ; Shulman, Stanford T ; Shortridge, Virginia D. ; Kabat, William ; Kabat, Kathy ; Cederlund, Emily ; Rippe, Jason ; Beyer, Jill ; Doktor, Stella ; Beall, Bernard W. / Community-based surveillance in the United States of macrolide-resistant pediatric pharyngeal group A streptococci during 3 respiratory disease seasons. In: Clinical Infectious Diseases. 2004 ; Vol. 39, No. 12. pp. 1794-1801.
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abstract = "Background. In 2001, a total of 48{\%} of pharyngeal group A streptococci (GAS) from Pittsburgh children were macrolide resistant. We assessed macrolide resistance, resistance genes, and emm types among GAS in the United States. Methods. In prospective, multicenter, community-based surveillance of pharyngeal GAS recovered from children 3-18 years old during 3 respiratory seasons (the 2000-2001 season, the 2001-2002 season, and the 2002-2003 season), GAS were tested for macrolide resistance and underwent emm gene sequencing. Macrolide-resistant GAS were tested for resistance to clindamycin, and resistance genes were determined. Results. Erythromycin resistance was observed in 4.4{\%} of isolates from the 2000-2001 season, 4.3{\%} from the 2001-2002 season, and 3.8{\%} from the 2002-2003 season (P = .80). Clindamycin resistance was found in 1.04{\%} of isolates; annual rates of clindamycin resistance were stable (P = .75). The predominant resistance genotype each year was mef A (65{\%}-76.9{\%}; overall, 70.3{\%}). Resistant isolates included strains representing 8-11 different emm types each year. Heterogeneity of emm subtypes, resistance genes, and clindamycin resistance was evident among resistant isolates within some emm types. Geographic variability in resistance rates was present each year. Conclusions. The macrolide resistance rate among pharyngeal GAS was <5{\%} and was stable over the 3 seasons. However, rates varied among sites each year. There was no evidence of spread of a specific resistant clone, increasing clindamycin resistance, or escalation in median erythromycin MICs.",
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Community-based surveillance in the United States of macrolide-resistant pediatric pharyngeal group A streptococci during 3 respiratory disease seasons. / Tanz, Robert R; Shulman, Stanford T; Shortridge, Virginia D.; Kabat, William; Kabat, Kathy; Cederlund, Emily; Rippe, Jason; Beyer, Jill; Doktor, Stella; Beall, Bernard W.

In: Clinical Infectious Diseases, Vol. 39, No. 12, 15.12.2004, p. 1794-1801.

Research output: Contribution to journalArticle

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T1 - Community-based surveillance in the United States of macrolide-resistant pediatric pharyngeal group A streptococci during 3 respiratory disease seasons

AU - Tanz, Robert R

AU - Shulman, Stanford T

AU - Shortridge, Virginia D.

AU - Kabat, William

AU - Kabat, Kathy

AU - Cederlund, Emily

AU - Rippe, Jason

AU - Beyer, Jill

AU - Doktor, Stella

AU - Beall, Bernard W.

PY - 2004/12/15

Y1 - 2004/12/15

N2 - Background. In 2001, a total of 48% of pharyngeal group A streptococci (GAS) from Pittsburgh children were macrolide resistant. We assessed macrolide resistance, resistance genes, and emm types among GAS in the United States. Methods. In prospective, multicenter, community-based surveillance of pharyngeal GAS recovered from children 3-18 years old during 3 respiratory seasons (the 2000-2001 season, the 2001-2002 season, and the 2002-2003 season), GAS were tested for macrolide resistance and underwent emm gene sequencing. Macrolide-resistant GAS were tested for resistance to clindamycin, and resistance genes were determined. Results. Erythromycin resistance was observed in 4.4% of isolates from the 2000-2001 season, 4.3% from the 2001-2002 season, and 3.8% from the 2002-2003 season (P = .80). Clindamycin resistance was found in 1.04% of isolates; annual rates of clindamycin resistance were stable (P = .75). The predominant resistance genotype each year was mef A (65%-76.9%; overall, 70.3%). Resistant isolates included strains representing 8-11 different emm types each year. Heterogeneity of emm subtypes, resistance genes, and clindamycin resistance was evident among resistant isolates within some emm types. Geographic variability in resistance rates was present each year. Conclusions. The macrolide resistance rate among pharyngeal GAS was <5% and was stable over the 3 seasons. However, rates varied among sites each year. There was no evidence of spread of a specific resistant clone, increasing clindamycin resistance, or escalation in median erythromycin MICs.

AB - Background. In 2001, a total of 48% of pharyngeal group A streptococci (GAS) from Pittsburgh children were macrolide resistant. We assessed macrolide resistance, resistance genes, and emm types among GAS in the United States. Methods. In prospective, multicenter, community-based surveillance of pharyngeal GAS recovered from children 3-18 years old during 3 respiratory seasons (the 2000-2001 season, the 2001-2002 season, and the 2002-2003 season), GAS were tested for macrolide resistance and underwent emm gene sequencing. Macrolide-resistant GAS were tested for resistance to clindamycin, and resistance genes were determined. Results. Erythromycin resistance was observed in 4.4% of isolates from the 2000-2001 season, 4.3% from the 2001-2002 season, and 3.8% from the 2002-2003 season (P = .80). Clindamycin resistance was found in 1.04% of isolates; annual rates of clindamycin resistance were stable (P = .75). The predominant resistance genotype each year was mef A (65%-76.9%; overall, 70.3%). Resistant isolates included strains representing 8-11 different emm types each year. Heterogeneity of emm subtypes, resistance genes, and clindamycin resistance was evident among resistant isolates within some emm types. Geographic variability in resistance rates was present each year. Conclusions. The macrolide resistance rate among pharyngeal GAS was <5% and was stable over the 3 seasons. However, rates varied among sites each year. There was no evidence of spread of a specific resistant clone, increasing clindamycin resistance, or escalation in median erythromycin MICs.

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