1
|
Sitkiewicz I, Borek A, Gryko M, Karpińska A, Kozińska A, Obszańska K, Wilemska-Dziaduszycka J, Walory J, Bańska A, Belkiewicz K, Foryś M, Gołębiewska A, Hryniewicz W, Kadłubowski M, Kiedrowska M, Klarowicz A, Matynia B, Ronkiewicz P, Szczypa K, Waśko I, Wawszczak M, Wróbel-Pawelczyk I, Zieniuk B. Epidemiology of Streptococcus pyogenes upper respiratory tract infections in Poland (2003-2017). J Appl Genet 2024; 65:635-644. [PMID: 38760644 PMCID: PMC11310251 DOI: 10.1007/s13353-024-00875-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 04/24/2024] [Accepted: 04/25/2024] [Indexed: 05/19/2024]
Abstract
Streptococcus pyogenes (group A Streptococcus, GAS) is a major human pathogen and causes every year over 600 millions upper respiratory tract onfections worldwide. Untreated or repeated infections may lead to post-infectional sequelae such as rheumatic heart disease, a major cause of GAS-mediated mortality. There is no comprehensive, longitudinal analysis of the M type distribution of upper respiratory tract strains isolated in Poland. Single reports describe rather their antibiotic resistance patterns or focus on the invasive isolates. Our goal was to analyse the clonal structure of the upper respiratory tract GAS isolated over multiple years in Poland. Our analysis revealed a clonal structure similar to the ones observed in high-income countries, with M1, M12, M89, M28, and M77 serotypes constituting over 80% of GAS strains. The M77 serotype is a major carrier of erythromycin resistance and is more often correlated with upper respiratory tract infections than other serotypes.
Collapse
Affiliation(s)
- Izabela Sitkiewicz
- Department of Biochemistry and Microbiology, Warsaw University of Life Sciences-SGGW, Nowoursynowska 159, 02-776, Warsaw, Poland.
| | - Anna Borek
- National Tuberculosis and Lung Diseases Research Institute, Płocka 26, 01-138, Warsaw, Poland
- National Medicines Institute, Chełmska 30/34, 00-725, Warsaw, Poland
| | - Monika Gryko
- National Medicines Institute, Chełmska 30/34, 00-725, Warsaw, Poland
| | - Aneta Karpińska
- National Medicines Institute, Chełmska 30/34, 00-725, Warsaw, Poland
| | | | - Katarzyna Obszańska
- Institute of Biochemistry and Biophysics, Polish Academy of Sciences, Pawińskiego 5A, 01-106, Warsaw, Poland
| | | | - Jarosław Walory
- National Medicines Institute, Chełmska 30/34, 00-725, Warsaw, Poland
| | - Agata Bańska
- ALAB Laboratory, Mikrobiologia, Ul. Stępińska 22/30, 00-739, Warsaw, Poland
| | - Katarzyna Belkiewicz
- National Tuberculosis and Lung Diseases Research Institute, Płocka 26, 01-138, Warsaw, Poland
- National Medicines Institute, Chełmska 30/34, 00-725, Warsaw, Poland
| | - Małgorzata Foryś
- National Medicines Institute, Chełmska 30/34, 00-725, Warsaw, Poland
| | | | - Waleria Hryniewicz
- National Medicines Institute, Chełmska 30/34, 00-725, Warsaw, Poland
- Centre of Quality Control in Microbiology (Polmicro), Rydygiera 8, 01-793, Warsaw, Poland
| | | | | | - Anna Klarowicz
- National Medicines Institute, Chełmska 30/34, 00-725, Warsaw, Poland
| | - Bożena Matynia
- National Medicines Institute, Chełmska 30/34, 00-725, Warsaw, Poland
| | | | - Katarzyna Szczypa
- National Medicines Institute, Chełmska 30/34, 00-725, Warsaw, Poland
| | - Izabela Waśko
- National Medicines Institute, Chełmska 30/34, 00-725, Warsaw, Poland
| | - Monika Wawszczak
- National Medicines Institute, Chełmska 30/34, 00-725, Warsaw, Poland
| | | | | |
Collapse
|
2
|
Rampersadh K, Engel KC, Engel ME, Moodley C. A survey of antibiotic resistance patterns among Group A Streptococcus isolated from invasive and non-invasive infections in Cape Town, South Africa. Heliyon 2024; 10:e33694. [PMID: 39040411 PMCID: PMC11261099 DOI: 10.1016/j.heliyon.2024.e33694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Accepted: 06/25/2024] [Indexed: 07/24/2024] Open
Abstract
Background There is concern regarding the increasing resistance of Group A streptococcus (GAS) to routinely used antibiotics. GAS is a common cause of bacterial pharyngitis and more severe invasive infections such as septicaemia. Furthermore, GAS pharyngitis is the antecedent for serious conditions such as rheumatic fever and rheumatic heart disease. The study aimed to determine the antimicrobial susceptibility patterns of GAS cultured from patients with invasive and non-invasive infections from Cape Town, as part of the AFROStrep Registry. Methods Samples were provided by the AFROStrep Registry, a continental endeavour aiming to document Streptococcus pyogenes infection in Africa and create the first biorepository of its kind. Ninety-five GAS isolates (invasive, n = 40; non-invasive, n = 55) were evaluated for resistance to a panel of 20 antibiotics using the Sensititre® STP6F system with MICs interpreted by CLSI break points. Results Amongst all isolates, highest levels of resistance were observed with respect to tetracycline (8.33 %), followed by azithromycin (1.04 %) and erythromycin (1.04 %). No resistance to the remaining antibiotics was detected amongst all isolates. No differences with regard to MIC values were observed between isolates from invasive and non-invasive infections (p-value >0.05 for all antibiotics). Conclusion GAS remains susceptible to routine-antimicrobial agents used in our low-resourced setting. Eight percent of the GAS isolates were resistant to tetracycline, and we did not observe macrolide resistance as reported in high income countries. This is the first study to report on the antimicrobial patterns of GAS in South Africa. These results address a critical gap in the available data on GAS in Africa and specifically South Africa and, thus, aid in avoiding therapeutic failures.
Collapse
Affiliation(s)
- Kimona Rampersadh
- AFROStrep Research Initiative & PROTEA/Cape Heart Institute., University of Cape Town, Department of Medicine, Observatory, South Africa
| | - Kelin C. Engel
- AFROStrep Research Initiative & PROTEA/Cape Heart Institute., University of Cape Town, Department of Medicine, Observatory, South Africa
| | - Mark E. Engel
- AFROStrep Research Initiative & PROTEA/Cape Heart Institute., University of Cape Town, Department of Medicine, Observatory, South Africa
- SA Cochrane Centre, South Africa Medical Research Council, Francie van Zijl Dr, Parow Valley 7501, South Africa
| | - Clinton Moodley
- Department of Pathology, Division of Medical Microbiology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- The National Health Laboratory Service, Microbiology, Groote Schuur Hospital, Cape Town, South Africa
| |
Collapse
|
3
|
Rafei R, Hawli M, Osman M, Dabboussi F, Hamze M. Distribution of emm types and macrolide resistance determinants among group A streptococci in the Middle East and North Africa region. J Glob Antimicrob Resist 2020; 22:334-348. [PMID: 32084609 DOI: 10.1016/j.jgar.2020.02.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 02/03/2020] [Accepted: 02/09/2020] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES The aim of this review was to provide an updated scenario on the epidemiology of group A streptococci (GAS) in the Middle East and North Africa (MENA) region with a special spotlight on the most prevalent emmtypes and macrolide resistance profiles. METHODS This review briefly summarises the disease burden for GAS in the MENA region. RESULTS Whilst the burden of invasive GAS infections is difficult to assess in the MENA region, the GAS prevalence ranged from 2.5% up to 42.4% in pharyngitis patients and from 2.4% up to 35.4% in healthy carriers.emm1, emm12, emm89, emm4, emm28 and emm3were responsible for the major GAS burden in the MENA region. The coverage rate of the new M protein-based vaccine candidate (30-valent) varied from 42% to 100% according to the country. The rate of erythromycin resistance differed substantially between countries from low to moderate or high. CONCLUSION These data add more shreds of evidence on the neglected GAS burden in the MENA region. Systematic surveillance of invasive GAS infections along with molecular characterisation of GAS isolates are strongly recommended to track the trends of circulating clones and to evaluate the potential coverage of vaccine candidates.
Collapse
Affiliation(s)
- Rayane Rafei
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Malaik Hawli
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Marwan Osman
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Fouad Dabboussi
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Monzer Hamze
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon.
| |
Collapse
|
4
|
Giménez MJ, Aguilar L, Granizo JJ. Revisiting cefditoren for the treatment of community-acquired infections caused by human-adapted respiratory pathogens in adults. Multidiscip Respir Med 2018; 13:40. [PMID: 30410757 PMCID: PMC6214181 DOI: 10.1186/s40248-018-0152-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 09/24/2018] [Indexed: 11/13/2022] Open
Abstract
Fifteen years after its licensure, this revision assesses the role of cefditoren facing the current pharmacoepidemiology of resistances in respiratory human-adapted pathogens (Streptococcus pneumoniae, Streptococcus pyogenes, Haemophilus influenzae and Moraxella catarrhalis). In the era of post- pneumococcal conjugate vaccines and in an environment of increasing diffusion of the ftsI gene among H. influenzae isolates, published studies on the cefditoren in vitro microbiological activity, pharmacokinetic/pharmcodynamic (PK/PD) activity and clinical efficacy are reviewed. Based on published data, an overall analysis is performed for PK/PD susceptibility interpretation. Further translation of PK/PD data into clinical/microbiological outcomes obtained in clinical trials carried out in the respiratory indications approved for cefditoren in adults (tonsillitis, sinusitis, acute exacerbation of chronic bronchitis and community-acquired pneumonia) is commented. Finally, the role of cefditoren within the current antibiotic armamentarium for the treatment of community respiratory tract infections in adults is discussed based on the revised information on its intrinsic activity, pharmacodynamic adequacy and clinical/bacteriological efficacy. Cefditoren remains an option to be taken into account when selecting an oral antibiotic for the empirical treatment of respiratory infections in the community caused by human-adapted pathogens, even when considering changes in the pharmacoepidemiology of resistances over the last two decades.
Collapse
Affiliation(s)
- María-José Giménez
- Research Department, PRISM-AG, Don Ramón de la Cruz 72, 28006 Madrid, Spain
| | - Lorenzo Aguilar
- Research Department, PRISM-AG, Don Ramón de la Cruz 72, 28006 Madrid, Spain
| | - Juan José Granizo
- Preventive Medicine Department, Hospital Universitario Infanta Cristina, Parla, Madrid, Spain
| |
Collapse
|
5
|
Extremely Low Prevalence of Erythromycin-Resistant Streptococcus pyogenes Isolates and Their Molecular Characteristics by M Protein Gene and Multilocus Sequence Typing Methods. Jundishapur J Microbiol 2018. [DOI: 10.5812/jjm.12779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
|
6
|
Muhtarova AA, Gergova RT, Mitov IG. Distribution of macrolide resistance mechanisms in Bulgarian clinical isolates of Streptococcus pyogenes during the years of 2013-2016. J Glob Antimicrob Resist 2017; 10:238-242. [PMID: 28735056 DOI: 10.1016/j.jgar.2017.05.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 05/11/2017] [Accepted: 05/27/2017] [Indexed: 10/19/2022] Open
Abstract
Streptococcus pyogenes, or group A streptococcus (GAS), is the main etiological agent of bacterial tonsillopharyngitis and a common cause of a wide variety of other mild to severe infections. OBJECTIVES Objectives of the present study was to determine and evaluate the distribution of genetic mechanisms associated with certain phenotypes of macrolide resistance in Bulgarian GAS isolated during the years of 2013-2016. METHODS All GAS strains were screened for the macrolide resistance genes erm(A), erm(B) and mef(A), using multiplex polymerase chain reaction (PCR). The minimal inhibitory concentrations (MICs) of erythromycin, azithromycin, clarithromycin, clindamycin were determined by E-tests. RESULTS Almost 23% of GAS isolates obtained in 2013-2014 and near 40% of them in 2015-2016 contained various elements of resistance. The predominant gene was mef(A), which encodes an efflux pump (M-phenotype), identified in 57.84% of the macrolide-resistant strains. The next frequently prevalent mechanism was a combination of mef(A) and erm(B) in 22.55%, which determined high-level inducible or constitutive resistance to macrolides, lincosamides and streptogramins (iMLSB or cMLSB). The highest MIC value (>256mg/L) was detected in association with erm(B) (p<0.05). The MIC range was observed to be much higher in the isolates with combinations of resistance genes vs. those with mef genes alone (p<0.05). CONCLUSION The data about the distribution and prevalence of macrolide resistance mechanisms obtained in this study can help in the treatment of persistent and recurrent GAS infections and in the correct choice of empiric therapy.
Collapse
Affiliation(s)
- Adile A Muhtarova
- Department of Medical Microbiology, Faculty of Medicine, Medical University, Sofia, Bulgaria
| | - Raina T Gergova
- Department of Medical Microbiology, Faculty of Medicine, Medical University, Sofia, Bulgaria.
| | - Ivan G Mitov
- Department of Medical Microbiology, Faculty of Medicine, Medical University, Sofia, Bulgaria
| |
Collapse
|
7
|
Delpech G, Sparo M, Baldaccini B, Pourcel G, Lissarrague S, García Allende L. Throat Carriage Rate and Antimicrobial Resistance of Streptococcus pyogenes In Rural Children in Argentina. J Prev Med Public Health 2017; 50:127-132. [PMID: 28372355 PMCID: PMC5398335 DOI: 10.3961/jpmph.15.073] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 12/18/2016] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES The aim of this study was to determine the prevalence of asymptomatic carriers of group A β-hemolytic streptococci (GAS) in children living in a rural community and to investigate the association between episodes of acute pharyngitis and carrier status. METHODS Throat swabs were collected from September to November 2013 among children 5-13 years of age from a rural community (Maria Ignacia-Vela, Argentina). The phenotypic characterization of isolates was performed by conventional tests. Antimicrobial susceptibility was assayed for penicillin, tetracycline, chloramphenicol, erythromycin, and clindamycin (disk diffusion). The minimum inhibitory concentration was determined for penicillin, cefotaxime, tetracycline, and erythromycin. RESULTS The carriage of β-hemolytic streptococci was detected in 18.1% of participants, with Streptococcus pyogenes in 18 participants followed by S. dysgalactiae ssp. equisimilis in 5. The highest proportion of GAS was found in 8 to 10-year-old children. No significant association between the number of episodes of acute pharyngitis suffered in the last year and the carrier state was detected (p>0.05). Tetracycline resistance (55.5%) and macrolide-resistant phenotypes (11.1%) were observed. Resistance to penicillin, cefotaxime, or chloramphenicol was not expressed in any streptococcal isolate. CONCLUSIONS The present study demonstrated significant throat carriage of GAS and the presence of group C streptococci (S. dysgalactiae ssp. equisimilis) in an Argentinian rural population. These results point out the need for continuous surveillance of GAS and non-GAS carriage as well as of antimicrobial resistance in highly susceptible populations, such as school-aged rural children. An extended surveillance program including school-aged children from different cities should be considered to estimate the prevalence of GAS carriage in Argentina.
Collapse
Affiliation(s)
- Gastón Delpech
- School of Medicine, Universidad Nacional del Centro de la Provincia de Buenos Aires, Olavarría, Argentina
| | - Mónica Sparo
- School of Medicine, Universidad Nacional del Centro de la Provincia de Buenos Aires, Olavarría, Argentina.,Hospital Ramón Santamarina, Tandil, Argentina
| | - Beatriz Baldaccini
- School of Medicine, Universidad Nacional del Centro de la Provincia de Buenos Aires, Olavarría, Argentina
| | - Gisela Pourcel
- School of Medicine, Universidad Nacional del Centro de la Provincia de Buenos Aires, Olavarría, Argentina
| | | | | |
Collapse
|
8
|
Sayyahfar S, Fahimzad A, Naddaf A, Tavassoli S. Antibiotic Susceptibility Evaluation of Group A Streptococcus Isolated from Children with Pharyngitis: A Study from Iran. Infect Chemother 2015; 47:225-30. [PMID: 26788405 PMCID: PMC4716273 DOI: 10.3947/ic.2015.47.4.225] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Revised: 06/25/2015] [Accepted: 06/25/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The aim of this study was to evaluate the antibiotic susceptibility of Group A streptococcus (GAS) to antibiotics usually used in Iran for treatment of GAS pharyngitis in children. MATERIALS AND METHODS From 2011 to 2013, children 3-15 years of age with acute tonsillopharyngitis who attended Mofid Children's Hospital clinics and emergency ward and did not meet the exclusion criteria were enrolled in a prospective study in a sequential manner. The isolates strains from throat culture were identified as GAS by colony morphology, gram staining, beta hemolysis on blood agar, sensitivity to bacitracin, a positive pyrrolidonyl aminopeptidase (PYR) test result, and the presence of Lancefield A antigen determined by agglutination test. Antimicrobial susceptibility was identified by both disk diffusion and broth dilution methods. RESULTS From 200 children enrolled in this study, 59 (30%) cases were culture positive for GAS. All isolates were sensitive to penicillin G. The prevalence of erythromycin, azithromycin, and clarithromycin resistance by broth dilution method was 33.9%, 57.6%, and 33.9%, respectively. Surprisingly, 8.4% of GAS strains were resistant to rifampin. In this study, 13.5% and 32.2% of the strains were resistant to clindamycin and ofloxacin, respectively. CONCLUSION The high rate of resistance of GAS to some antibiotics in this study should warn physicians, especially in Iran, to use antibiotics restrictedly and logically to prevent the rising of resistance rates in future. It also seems that continuous local surveillance is necessary to achieve the best therapeutic option for GAS treatment.
Collapse
Affiliation(s)
- Shirin Sayyahfar
- Division of Pediatric Infectious Diseases, Departement of Pediatrics, Ali Asghar Children Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Fahimzad
- Division of Pediatric Infectious Diseases, Departement of Pediatrics, Pediatric Infectious Research Center, Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Naddaf
- Department of Pediatrics, Fasa University of Medical sciences, Fasa, Iran
| | - Sara Tavassoli
- Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
9
|
Marini E, Magi G, Mingoia M, Pugnaloni A, Facinelli B. Antimicrobial and Anti-Virulence Activity of Capsaicin Against Erythromycin-Resistant, Cell-Invasive Group A Streptococci. Front Microbiol 2015; 6:1281. [PMID: 26617603 PMCID: PMC4643145 DOI: 10.3389/fmicb.2015.01281] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 10/31/2015] [Indexed: 12/02/2022] Open
Abstract
Capsaicin (8-methyl-N-vanillyl-6-nonenamide) is the active component of Capsicum plants (chili peppers), which are grown as food and for medicinal purposes since ancient times, and is responsible for the pungency of their fruit. Besides its multiple pharmacological and physiological properties (pain relief, cancer prevention, and beneficial cardiovascular, and gastrointestinal effects) capsaicin has recently attracted considerable attention because of its antimicrobial and anti-virulence activity. This is the first study of its in vitro antibacterial and anti-virulence activity against Streptococcus pyogenes (Group A streptococci, GAS), a major human pathogen. The test strains were previously characterized, erythromycin-susceptible (n = 5) and erythromycin-resistant (n = 27), cell-invasive pharyngeal isolates. The MICs of capsaicin were 64–128 μg/mL (the most common MIC was 128 μg/mL). The action of capsaicin was bactericidal, as suggested by MBC values that were equal or close to the MICs, and by early detection of dead cells in the live/dead assay. No capsaicin-resistant mutants were obtained in single-step resistance selection studies. Interestingly, growth in presence of sublethal capsaicin concentrations induced an increase in biofilm production (p ≤ 0.05) and in the number of bacteria adhering to A549 monolayers, and a reduction in cell-invasiveness and haemolytic activity (both p ≤ 0.05). Cell invasiveness fell so dramatically that a highly invasive strain became non-invasive. The dose-response relationship, characterized by opposite effects of low and high capsaicin doses, suggests a hormetic response. The present study documents that capsaicin has promising bactericidal activity against erythromycin-resistant, cell-invasive pharyngeal GAS isolates. The fact that sublethal concentrations inhibited cell invasion and reduced haemolytic activity, two important virulence traits of GAS, is also interesting, considering that cell-invasive, erythromycinresistant strains can evade β-lactams by virtue of intracellular location and macrolides by virtue of resistance, thus escaping antibiotic treatment. By inhibiting intracellular invasion and haemolytic activity, capsaicin could thus prevent both formation of a difficult to eradicate intracellular reservoir, and infection spread to deep tissues.
Collapse
Affiliation(s)
- Emanuela Marini
- Unit of Microbiology, Department of Biomedical Sciences and Public Health, Polytechnic University of Marche , Ancona, Italy
| | - Gloria Magi
- Unit of Microbiology, Department of Biomedical Sciences and Public Health, Polytechnic University of Marche , Ancona, Italy
| | - Marina Mingoia
- Unit of Microbiology, Department of Biomedical Sciences and Public Health, Polytechnic University of Marche , Ancona, Italy
| | - Armanda Pugnaloni
- Department of Clinical and Molecular Sciences, Polytechnic University of Marche , Ancona, Italy
| | - Bruna Facinelli
- Unit of Microbiology, Department of Biomedical Sciences and Public Health, Polytechnic University of Marche , Ancona, Italy
| |
Collapse
|
10
|
Magi G, Marini E, Facinelli B. Antimicrobial activity of essential oils and carvacrol, and synergy of carvacrol and erythromycin, against clinical, erythromycin-resistant Group A Streptococci. Front Microbiol 2015; 6:165. [PMID: 25784902 PMCID: PMC4347498 DOI: 10.3389/fmicb.2015.00165] [Citation(s) in RCA: 125] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 02/12/2015] [Indexed: 01/27/2023] Open
Abstract
In the present study, we have evaluated the in vitro antibacterial activity of essential oils from Origanum vulgare, Thymus vulgaris, Lavandula angustifolia, Mentha piperita, and Melaleuca alternifolia against 32 erythromycin-resistant [Mininum Inhibitory Concentration (MIC) ≥1 μg/mL; inducible, constitutive, and efflux-mediated resistance phenotype; erm(TR), erm(B), and mef(A) genes] and cell-invasive Group A streptococci (GAS) isolated from children with pharyngotonsillitis in Italy. Over the past decades erythromycin resistance in GAS has emerged in several countries; strains combining erythromycin resistance and cell invasiveness may escape β-lactams because of intracellular location and macrolides because of resistance, resulting in difficulty of eradication and recurrent pharyngitis. Thyme and origanum essential oils demonstrated the highest antimicrobial activity with MICs ranging from 256 to 512 μg/mL. The phenolic monoterpene carvacrol [2-Methyl-5-(1-methylethyl) phenol] is a major component of the essential oils of Origanum and Thymus plants. MICs of carvacrol ranged from 64 to 256 μg/mL. In the live/dead assay several dead cells were detected as early as 1 h after incubation with carvacrol at the MIC. In single-step resistance selection studies no resistant mutants were obtained. A synergistic action of carvacrol and erythromycin was detected by the checkerboard assay and calculation of the Fractional Inhibitory Concentration (FIC) Index. A 2- to 2048-fold reduction of the erythromycin MIC was documented in checkerboard assays. Synergy (FIC Index ≤0.5) was found in 21/32 strains and was highly significant (p < 0.01) in strains where resistance is expressed only in presence of erythromycin. Synergy was confirmed in 17/23 strains using 24-h time-kill curves in presence of carvacrol and erythromycin. Our findings demonstrated that carvacrol acts either alone or in combination with erythromycin against erythromycin-resistant GAS and could potentially serve as a novel therapeutic tool.
Collapse
Affiliation(s)
- Gloria Magi
- Unit of Microbiology, Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, Ancona Italy
| | - Emanuela Marini
- Unit of Microbiology, Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, Ancona Italy
| | - Bruna Facinelli
- Unit of Microbiology, Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, Ancona Italy
| |
Collapse
|
11
|
Karaky NM, Araj GF, Tokajian ST. Molecular characterization of Streptococcus pyogenes group A isolates from a tertiary hospital in Lebanon. J Med Microbiol 2014; 63:1197-1204. [PMID: 24980572 DOI: 10.1099/jmm.0.063412-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Streptococcus pyogenes [Group A Streptococcus (GAS)] is one of the most important human pathogens, responsible for numerous diseases with diverse clinical manifestations. As the epidemiology of GAS infections evolves, a rapid and reliable characterization of the isolates remains essential for epidemiological analysis and infection control. This study investigated the epidemiological patterns and genetic characteristics of 150 GAS isolates from a tertiary hospital in Lebanon by emm typing, superantigens (SAgs) detection, PFGE and antibiotic profiling. The results revealed 41 distinct emm types, the most prevalent of which were emm89 (16 %), emm12 (10 %), emm2 (9 %) and emm1 (8 %). Testing for the presence of superantigens showed that speB (87 %), ssa (36 %) and speG (30 %) were predominant. PFGE detected 39 pulsotypes when a similarity cut-off value of 80 % was implemented. Antibiotic-susceptibility testing against seven different classes of antibiotics showed that 9 % of the isolates were resistant to clindamycin, 23 % were resistant to erythromycin and 4 % showed the macrolide-lincosamide-streptogramin B (MLSB) phenotype. The emergence of tetracycline-resistant strains (37 %) was high when compared with previous reports from Lebanon. This study provided comprehensive evidence of the epidemiology of GAS in Lebanon, highlighting the association between emm types and toxin genes, and providing valuable information about the origin and dissemination of this pathogen.
Collapse
Affiliation(s)
- Nathalie M Karaky
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Byblos, Lebanon
| | - George F Araj
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Sima T Tokajian
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Byblos, Lebanon
| |
Collapse
|
12
|
Camara M, Dieng A, Boye CSB. Antibiotic susceptibility of streptococcus pyogenes isolated from respiratory tract infections in dakar, senegal. Microbiol Insights 2013; 6:71-5. [PMID: 24826076 PMCID: PMC3987753 DOI: 10.4137/mbi.s12996] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Group A Streptococcus (GAS) is one of the major causes of respiratory tract infections. The objectives of this study were to identify isolates of S. pyogenes obtained from respiratory tract infections, and to assess their susceptibility to several antibiotics. A total of 40 strains were isolated and their susceptibility to 17 antibiotics was tested using a standard disk diffusion method. The minimum inhibitory concentrations (MICs) were determined using the E-test. All isolates were sensitive to β-lactam antibiotics including penicillin, amoxicillin, and cephalosporins. Macrolides remain active with the exception of spiramycin, which showed reduced susceptibility. Out of the 40 isolates, 100% of the isolates were resistant to tetracycline. Interestingly, isolates were sensitive to chloramphenicol, teicoplanin, vancomycine, and levofloxacin, providing potential alternative choices of treatment against infections with S. pyogenes.
Collapse
Affiliation(s)
- Makhtar Camara
- Laboratory of Bacteriology-Virology, Centre Hospitalier Universitaire Le Dantec, Cheikh Anta DIOP University, Dakar, Senegal
| | - Assane Dieng
- Laboratory of Bacteriology-Virology, Centre Hospitalier Universitaire Le Dantec, Cheikh Anta DIOP University, Dakar, Senegal
| | - Cheikh Saad Bouh Boye
- Laboratory of Bacteriology-Virology, Centre Hospitalier Universitaire Le Dantec, Cheikh Anta DIOP University, Dakar, Senegal
| |
Collapse
|
13
|
Mazur E. Management of acute streptococcal pharyngitis: still the subject of controversy. CENTRAL EUROPEAN JOURNAL OF MEDICINE 2013; 8:713-719. [PMID: 32215121 PMCID: PMC7089329 DOI: 10.2478/s11536-013-0216-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Accepted: 05/03/2013] [Indexed: 11/30/2022]
Abstract
Although most cases of acute pharyngitis are viral in origin, antibiotics are overused in its treatment. Streptococcus pyogenes (group A streptococcus, GAS), the principal bacterial pathogen of acute sore throat, is responsible for merely 5-30% of cases. Moreover, GAS pharyngitis is currently the only commonly occurring form of acute pharyngitis for which antibiotic therapy is definitely indicated. Therefore the differentiation between GAS pharyngitis and that of viral etiology is crucial. Accordingly, scientific societies as well as respected advisory bodies in Europe and North America, issued guidelines for the management of acute pharyngitis with the aim of minimizing unnecessary antibiotic prescriptions in its treatment. The aim of this review work is to confront the state of the art in acute GAS pharyngitis diagnosis and treatment with different approaches to its management represented by current European and North American guidelines. Although based on scientific evidence, international guidelines differ substantially in opinions whether GAS pharyngitis diagnosis should be based on microbiological testing, clinical algorithm or a combination of both. On the other hand, some European guidelines consider GAS pharyngitis to be a mild, self-limiting disease that does not require a specific diagnosis or antimicrobial treatment except in high-risk patients. There is an agreement among guidelines that if antibiotic therapy is indicated, phenoxymethyl penicillin should be the drug of choice to treat GAS pharyngitis.
Collapse
Affiliation(s)
- Elżbieta Mazur
- Medical Microbiology Department, Medical University of Lublin, ul. Chodźki 1, 20-093 Lublin, Poland
| |
Collapse
|
14
|
Blasi F, Tarsia P, Mantero M, Morlacchi LC, Piffer F. Cefditoren versus levofloxacin in patients with exacerbations of chronic bronchitis: serum inflammatory biomarkers, clinical efficacy, and microbiological eradication. Ther Clin Risk Manag 2013; 9:55-64. [PMID: 23430960 PMCID: PMC3575210 DOI: 10.2147/tcrm.s41131] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background The aim of this open-label, randomized, parallel-group pilot study was to evaluate the efficacy of cefditoren pivoxil and levofloxacin in terms of speed of reduction in inflammatory parameters, clinical recovery, and microbiological eradication. Methods Forty eligible patients with acute exacerbation of chronic bronchitis (AECB) were randomized to receive cefditoren 200 mg twice a day for 5 days (n = 20) or levofloxacin 500 mg once daily for 7 days (n = 20). Results The inflammatory parameters which were significantly reduced at test-of-cure with respect to visit 1 were Krebs von den Lundgen-6 (KL-6) and interleukin-6. KL-6 decreased both in the overall study population (from 19 ± 11 UI/mL to 6 ± 8 UI/mL, P = 0.000) and in the cefditoren (from 19 ± 13 UI/mL to 8 ± 10 UI/mL, P = 0.006) and levofloxacin (from 19 ± 10 UI/mL to 5 ± 5 UI/mL, P = 0.000) arms. Similarly, interleukin-6 decreased both in the overall study population (from 13.35 ± 16.41 pg/mL to 3 ± 4.7 pg/mL, P = 0.000) and in the cefditoren (from 15.90 ± 19.54 pg/mL to 4.13 ± 6.42 pg/mL, P = 0.015) and levofloxacin (from 10.80 ± 12.55 pg/mL to 1.87 ± 1.16 pg/mL, P = 0.003) arms. At the end of treatment (test-of-cure, 6–9 days after drug initiation), the clinical success rate in the overall study population was 78%; the clinical cure rate was 80% in the cefditoren arm and 75% in the levofloxacin arm. Globally, bacteriological eradication at test-of-cure was obtained in 85% of the overall study population. Both treatments were well tolerated. Conclusion Cefditoren represents a valid option in the treatment of mild to moderately severe cases of AECB in the outpatient care setting. Moreover, the use of this cephalosporin is associated with a significant reduction of interleukin-6 and KL-6, two key mediators of lung inflammation and epithelial damage.
Collapse
Affiliation(s)
- Francesco Blasi
- Department of Pathophysiology and Transplantation, University of Milan, IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | | | | | | |
Collapse
|
15
|
Antibacterial Activity of Rhodomyrtus tomentosa (Aiton) Hassk. Leaf Extract against Clinical Isolates of Streptococcus pyogenes. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 2012:697183. [PMID: 22973404 PMCID: PMC3438885 DOI: 10.1155/2012/697183] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Revised: 07/26/2012] [Accepted: 07/31/2012] [Indexed: 11/18/2022]
Abstract
Ethanol extract of Rhodomyrtus tomentosa (Aiton) Hassk. leaf was evaluated for antibacterial activity against 47 clinical isolates of Streptococcus pyogenes. The extract exhibited good anti-S. pyogenes activity against all the tested isolates with similar minimum inhibitory concentration (MIC, 3.91-62.5 μg mL(-1)) and minimum bactericidal concentration (MBC, 3.91-62.5 μg mL(-1)) ranges. No surviving cells were detected at 16 h after treatment with 8 × MIC of the extract. The extract-treated cells demonstrated no lysis and cytoplasmic leakage through the bacterial membrane. Electron micrographs further revealed that the extract did not cause any dramatic changes on the treated cells. Rhodomyrtone, an isolated compound, exhibited good anti-S. pyogenes activity (14 isolates), expressed very low MIC (0.39-1.56 μg mL(-1)) and MBC (0.39-1.56 μg mL(-1)) values. Rhodomyrtus tomentosa leaf extract and rhodomyrtone displayed promising antibacterial activity against clinical isolates of S. pyogenes.
Collapse
|
16
|
Soriano F, Giménez MJ, Aguilar L. Pharmacodynamics for predicting therapeutic outcome and countering resistance spread: The cefditoren case. World J Clin Infect Dis 2012; 2:28-38. [DOI: 10.5495/wjcid.v2.i3.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The relationship between pharmacokinetics and pharmacodynamics is a key instrument to improve antimicrobial stewardship and should be aimed to identification of the drug exposure measure that is closely associated not only with the ability to kill organisms but also to suppress the emergence of resistant subpopulations. This article reviews published studies for efficacy prediction with cefditoren and those aimed to explore its potential for countering resistance spread, focusing on the three most prevalent community-acquired isolates from respiratory infections: Streptococcus pneumoniae (S. pneumoniae), Haemophilus influenzae (H. influenzae) and Streptococcus pyogenes (S. pyogenes). Studies for efficacy prediction include in vitro pharmacodynamic simulations (using physiological concentrations of human albumin) and mice models (taking advantage of the same protein binding rate in mice and humans) to determine the value of the pharmacodynamic indices predicting efficacy, and Monte Carlo simulations to explore population pharmacodynamic coverage, as weapons for establishing breakpoints. Studies exploring the potential of cefditoren (free concentrations obtained with 400 mg cefditoren bid administration) for countering spread of resistance showed its capability for countering (1) intra-strain spread of resistance linked to ftsI gene mutations in H. influenzae; (2) the spread of H. influenzae resistant strains (with ftsI gene mutations) in multi-strain H. influenzae niches or of S. pneumoniae strains with multiple resistance traits in multi-strain S. pneumoniae niches; and (3) for overcoming indirect pathogenicity linked to β-lactamase production by H. influenzae that protects S. pyogenes in multibacterial niches. This revision evidences the ecological potential for cefditoren (countering resistance spread among human-adapted commensals) and its adequate pharmacodynamic coverage of respiratory pathogens (including those resistant to previous oral compounds) producing community-acquired infections.
Collapse
|
17
|
Barberán J, Aguilar L, Giménez MJ. Update on the clinical utility and optimal use of cefditoren. Int J Gen Med 2012; 5:455-64. [PMID: 22675264 PMCID: PMC3367410 DOI: 10.2147/ijgm.s25989] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
This article reviews and updates published data on cefditoren. The in vitro activity of cefditoren and its potential pharmacokinetic/pharmacodynamic adequacy to cover emerging resistance phenotypes in the present decade is reviewed. Cefditoren’s in vitro activity against most prevalent bacterial respiratory pathogens in the community and its pharmacokinetic/pharmacodynamic profile suggests a significant role for cefditoren in the treatment of respiratory tract infections. Clinical trials (in acute exacerbations of chronic bronchitis, community-acquired pneumonia, pharyngotonsillitis, and sinusitis) performed during clinical development outside Japan, mainly in adults, are reviewed, together with new clinical studies in the treatment of pharyngotonsillitis, sinusitis, and otitis media in children, mainly in Japan, for efficacy and safety assessment. The results of these studies support the adequacy of cefditoren for the treatment of community-acquired respiratory tract infections with a safety profile similar to previous oral antibiotics. From the data reviewed, it is concluded that cefditoren is an adequate option for the treatment of mild-to-moderate community-acquired respiratory infections, especially in geographical areas with a reported prevalence of phenotypes exhibiting nonsusceptibility to common oral antibiotics.
Collapse
Affiliation(s)
- José Barberán
- Infectious Diseases Department, Hospital Central de la Defensa Gomez Ulla, Madrid, Spain
| | | | | |
Collapse
|
18
|
Limsuwan S, Hesseling-Meinders A, Voravuthikunchai SP, van Dijl JM, Kayser O. Potential antibiotic and anti-infective effects of rhodomyrtone from Rhodomyrtus tomentosa (Aiton) Hassk. on Streptococcus pyogenes as revealed by proteomics. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2011; 18:934-940. [PMID: 21439802 DOI: 10.1016/j.phymed.2011.02.007] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2010] [Revised: 12/28/2010] [Accepted: 02/07/2011] [Indexed: 05/30/2023]
Abstract
Rhodomyrtone from Rhodomyrtus tomentosa (Aiton) Hassk. leaf extract has a strong antibacterial activity against the bacterial pathogen Streptococcus pyogenes. Our previous studies indicated that the bactericidal activity of rhodomyrtone might involve intracellular targets. In the present studies we followed a proteomics approach to investigate the mode of action of rhodomyrtone on S. pyogenes. For this purpose, S. pyogenes was cultivated in the presence of 0.39 μg/ml rhodomyrtone, which corresponds to 50% of the minimal inhibitory concentration. The results show that the amounts of various enzymes associated with important metabolic pathways were strongly affected, which is consistent with the growth-inhibiting effect of rhodomyrtone. Additionally, cells of S. pyogenes grown in the presence of rhodomyrtone produced reduced amounts of known virulence factors, such as the glyceraldehyde-3-phosphate dehydrogenase, the CAMP factor, and the streptococcal pyrogenic exotoxin C. Taken together, these findings indicate that rhodomyrtone has both antimicrobial and anti-infective activities, which make it an interesting candidate drug.
Collapse
Affiliation(s)
- Surasak Limsuwan
- Faculty of Traditional Thai Medicine and Natural Products Research Center, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90112, Thailand
| | | | | | | | | |
Collapse
|
19
|
Soriano F, Giménez MJ, Aguilar L. Cefditoren in upper and lower community-acquired respiratory tract infections. Drug Des Devel Ther 2011; 5:85-94. [PMID: 21340042 PMCID: PMC3038999 DOI: 10.2147/dddt.s9499] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2011] [Indexed: 11/23/2022] Open
Abstract
This article reviews and updates published data on cefditoren in the evolving scenario of resistance among the most prevalent isolates from respiratory tract infections in the community (Streptococcus pyogenes, Haemophilus influenzae, and Streptococcus pneumoniae). By relating the in vitro activity of cefditoren (in national and multinational surveillance and against isolates with emerging resistant genotypes/phenotypes) to its pharmacokinetics, the cefditoren pharmacodynamic activity predicting efficacy (in humans, animal models, and in vitro simulations) is analyzed prior to reviewing clinical studies (tonsillopharyngitis, sinusitis, acute exacerbations of chronic bronchitis, and community-acquired pneumonia) and the relationship between bacterial eradication and clinical efficacy. The high in vitro activity of cefditoren against the most prevalent respiratory isolates in the community, together with its pharmacokinetics (enabling a twice daily regimen) leading to adequate pharmacodynamic indexes covering all S. pyogenes, H. influenzae, and at least 95% S. pneumoniae isolates, makes cefditoren an antibiotic that will play a significant role in the treatment of respiratory tract infections in the community. In the clinical setting, studies carried out with cefditoren showed that treatments with the 400 mg twice daily regimen were associated with high rates of bacteriological response, even against penicillin-nonsusceptible S. pneumoniae, with good correlation between bacteriological efficacy/response and clinical outcome.
Collapse
|
20
|
Bahnan W, Hashwa F, Araj G, Tokajian S. emm typing, antibiotic resistance and PFGE analysis of Streptococcus pyogenes in Lebanon. J Med Microbiol 2010; 60:98-101. [PMID: 20864546 DOI: 10.1099/jmm.0.023317-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
One hundred and three Streptococcus pyogenes isolates recovered mainly from streptococcal throat infections in Lebanon were characterized by emm and PFGE typing. Thirty-three emm types and subtypes were detected among the isolates. PFGE was more discriminatory as a typing method. The prevalent emm types were emm1 (12.6 %), emm22 (8.7 %), emm28 (7.7 %), emm88 (7.7 %) and emm4 (6.8 %) and all isolates were susceptible to vancomycin and penicillin G. Ten per cent of the isolates were resistant to erythromycin and 3 % were resistant to erythromycin and clindamycin, showing the macrolide-lincosamide-streptogramin B phenotype. The emm sequences and PFGE pattern database that were generated in this study will serve as a basis for information for long-term evolutionary and epidemiological studies of local S. pyogenes recovered not only in Lebanon, but also in neighbouring countries.
Collapse
Affiliation(s)
- Wael Bahnan
- Department of Biology, School of Arts and Sciences, Lebanese American University, Byblos, Lebanon
| | - Fuad Hashwa
- Department of Biology, School of Arts and Sciences, Lebanese American University, Byblos, Lebanon
| | - George Araj
- Department of Pathology and Laboratory Medicine, American University of Beirut, Medical Centre, Beirut, Lebanon
| | - Sima Tokajian
- Department of Biology, School of Arts and Sciences, Lebanese American University, Byblos, Lebanon
| |
Collapse
|
21
|
Banche G, Tullio V, Allizond V, Mandras N, Roana J, Scalas D, El Fassi F, D'Antico S, Cuffini AM, Carlone N. Synergistic effect of erythromycin on polymorphonuclear cell antibacterial activity against erythromycin-resistant phenotypes of Streptococcus pyogenes. Int J Antimicrob Agents 2010; 36:319-23. [PMID: 20692129 DOI: 10.1016/j.ijantimicag.2010.06.041] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2010] [Revised: 06/16/2010] [Accepted: 06/18/2010] [Indexed: 01/25/2023]
Abstract
To evaluate the synergistic activity of erythromycin and human polymorphonuclear cells (PMNs) on the binomial erythromycin-resistant (ERY(R)) Streptococcus pyogenes/host, the phagocytic and bactericidal activities of PMNs against ERY(R) streptococcal strains (cMLS(B), M, and iMLS(B) A, B and C phenotypes) were assessed in the presence of the macrolide. The results showed that when erythromycin, PMNs and streptococci [both erythromycin-sensitive (ERY(S)) and ERY(R)] were simultaneously present in the culture medium, PMN phagocytic activity was similar to that of drug-free controls. In contrast, the results emphasised a significant high increase in intracellular killing by PMNs in the presence of erythromycin not only for ERY(S) streptococci but also for ERY(R)S. pyogenes with high (cMLS(B), iMLS(B) A and iMLS(B) B phenotypes) and moderate (M and iMLS(B) C phenotypes) erythromycin resistance compared with controls without drug. From literature data it emerged that, even if intracellularly concentrated, erythromycin is relatively inactive because of its instability. The results indicate that the enhanced intra-PMN streptococcal killing detected is mainly attributable to PMN bactericidal systems that synergise with intracellular erythromycin in eradicating ERY(R)S. pyogenes strains (both with high and moderate resistance). These data confirm that the antibiotic resistance detected in vitro does not always imply a failure of antimicrobial treatment.
Collapse
Affiliation(s)
- Giuliana Banche
- Department of Public Health and Microbiology, University of Turin, Via Santena 9, 10126 Turin, Italy
| | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Biotypes et sensibilité aux antibiotiques des souches de Streptococcus pyogenes isolées chez des enfants à Tunis. ACTA ACUST UNITED AC 2010; 103:69-74. [DOI: 10.1007/s13149-010-0053-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2009] [Accepted: 01/26/2010] [Indexed: 11/25/2022]
|
23
|
Time–kill kinetics of oritavancin and comparator agents against Streptococcus pyogenes. Int J Antimicrob Agents 2009; 34:550-4. [DOI: 10.1016/j.ijantimicag.2009.08.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2009] [Revised: 08/13/2009] [Accepted: 08/14/2009] [Indexed: 11/24/2022]
|