TY - JOUR
T1 - Genetic commonality of macrolide-resistant group A beta hemolytic streptococcus pharyngeal strains
AU - Myers, Angela L.
AU - Jackson, Mary A.
AU - Selvarangan, Rangaraj
AU - Goering, Richard V.
AU - Harrison, Christopher
N1 - Funding Information:
This study was funded by a Katherine Berry Richardson grant through Children's Mercy Hospitals & Clinics. Pulse field gel electrophoresis was conducted and analyzed at Creighton University under the supervision of Richard V. Goering, PhD, Kristin K. Bonstetter, MS, and Daniel J. Wolter, PhD. Specimen collection at site B was conducted by Michelle McIntosh, MD, and Trina Lamphear
PY - 2009/12/1
Y1 - 2009/12/1
N2 - Background: Group A beta hemolytic streptococcus (GABHS) pharyngitis is a common childhood illness. Penicillin remains the gold standard therapy, but macrolides are indicated for the penicillin allergic patient, and are often used for convenience. Methods: We conducted a surveillance study of children with pharyngitis and positive streptococcal rapid antigen testing from 10/05 to 10/06 at 2 sites (A & B). Demographics, treatment, and resistance data was collected and compared to previous data from 2002. Erythromycin (EM) resistance was determined by disk diffusion and E-test on 500 isolates. Pulse field gel electrophoresis (PFGE) was performed to measure genetic relatedness of isolates. StatXact version 8 software (Cytel Inc., Cambridge, MA) was utilized to perform Fisher's exact test and exact confidence interval (CI) analysis. Results: There were no differences in resistance rates or demographic features, with the exception of race, between sites A & B. EM resistance was 0 in 2002, 3.5% in 2005-06 at site A, and 4.5% in 2005-06 at site B. 3/7 and 3/9 had inducible resistance at A and B respectively. 8 isolates had relatedness ≥80%, 5 of which were 88% homologous on PFGE. Conclusion: Community macrolide resistance has increased following increased macrolide use. These results may have treatment implications if use continues to be high.
AB - Background: Group A beta hemolytic streptococcus (GABHS) pharyngitis is a common childhood illness. Penicillin remains the gold standard therapy, but macrolides are indicated for the penicillin allergic patient, and are often used for convenience. Methods: We conducted a surveillance study of children with pharyngitis and positive streptococcal rapid antigen testing from 10/05 to 10/06 at 2 sites (A & B). Demographics, treatment, and resistance data was collected and compared to previous data from 2002. Erythromycin (EM) resistance was determined by disk diffusion and E-test on 500 isolates. Pulse field gel electrophoresis (PFGE) was performed to measure genetic relatedness of isolates. StatXact version 8 software (Cytel Inc., Cambridge, MA) was utilized to perform Fisher's exact test and exact confidence interval (CI) analysis. Results: There were no differences in resistance rates or demographic features, with the exception of race, between sites A & B. EM resistance was 0 in 2002, 3.5% in 2005-06 at site A, and 4.5% in 2005-06 at site B. 3/7 and 3/9 had inducible resistance at A and B respectively. 8 isolates had relatedness ≥80%, 5 of which were 88% homologous on PFGE. Conclusion: Community macrolide resistance has increased following increased macrolide use. These results may have treatment implications if use continues to be high.
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U2 - 10.1186/1476-0711-8-33
DO - 10.1186/1476-0711-8-33
M3 - Article
C2 - 19951439
AN - SCOPUS:71949130152
VL - 8
JO - Annals of Clinical Microbiology and Antimicrobials
JF - Annals of Clinical Microbiology and Antimicrobials
SN - 1476-0711
M1 - 33
ER -