Incidence of macrolide–lincosamide–streptogramin B resistance amongst beta-haemolytic streptococci in The Gambia

Springer Science and Business Media LLC - 2017
Ebenezer Foster-Nyarko1, Brenda Kwambana1, Fatima Ceesay1, Kaddijatou Jawneh1, Saffiatou Darboe2, Sarah N. Mulwa1, Buntung Ceesay2, Ousman O. Secka2, Ifedayo Adetifa3,4, Martin Antonio5,1,6
1Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia
2Clinical Microbiology Department, Medical Research Council Unit The Gambia, Banjul, The Gambia
3Disease Control and Elimination Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia
4Infectious Diseases Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
5Microbiology and Infection Unit, Warwick Medical School, University of Warwick, Coventry, UK
6Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK

Tóm tắt

In West Africa, penicillin, macrolide and lincosamide resistance among beta-haemolytic streptococci (BHS) isolates has rarely been described. However, such data are critical to detect and track the emergence of antibiotic resistance. Beta-haemolytic streptococci were cultured from clinical specimens from patients attending the clinic at the Medical Research Council Unit The Gambia (n = 217) and kept at −70 °C. Of these, 186 were revived and tested for penicillin susceptibility by disc diffusion and E-test methods, and the D-test for determination of constitutive and inducible macrolide–lincosamide (MLSB) resistance phenotypes. The majority of BHS isolates from infections were group A streptococci (GAS) (126/186, 67.7%). Of these, 16% were from invasive disease (30/186). Other BHS isolated included lancefield groups B (19, 10.2%); C (9/186, 4.8%), D (3/186, 1.6%), F (5/186, 2.7%), G (16/186, 8.6%) and non-typeable (8/186, 4.3%). Prevalence of BHS isolated from blood cultures ranges from 0% (2005) to 0.5% (2010). Most (85, 45.7%) of the isolates were from wound infections. Of the 186 BHS isolates, none was resistant to penicillin and 14 (6.1%) were resistant to erythromycin. Of these, 8 (4.3%) demonstrated constitutive MLSB resistance, and 5 (2.7%) were inducible MLSB resistant. All the inducible MLSB isolates were GAS, and majority of the constitutive MLSB isolates (6/8, 75.0%) were non-GAS. Beta-haemolytic streptococci, predominantly GAS are associated with a wide range of infections in The Gambia. It is reassuring that macrolide and lincosamide resistance is relatively low. However, monitoring of MLSB resistance is necessary with the global spread of resistant BHS strains.

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