tetracycline and Streptococcal-Infections

Maternal rectovaginal colonization with group B Streptococcus (GBS) or Streptococcus agalactiae is the most common pathway for this disease during the perinatal period. This meta-analysis aimed to summarize existing data regarding maternal colonization, serotype profiles, and antibiotic resistance in China.. Systematic literature reviews were conducted after searching 6 databases. Meta-analysis was applied to analyze colonization rate, serotype, and antimicrobial susceptibility of GBS clinical isolates in different regions of China. Summary estimates are presented using tables, funnel plots, forest plots, histograms, violin plots, and line plots.. The dataset regarding colonization included 52 articles and 195 303 pregnant women. Our estimate for maternal GBS colonization in China was 8.1% (95% confidence interval [CI] 7.2%-8.9%). Serotypes Ia, Ib, III, and V account for 95.9% of identified isolates. Serotype III, which is frequently associated with the hypervirulent clonal complex, accounts for 46.4%. Among the maternal GBS isolates using multilocus sequence typing (MLST), ST19 (25.7%, 289/1126) and ST10 (25.1%, 283/1126) were most common, followed by ST12 (12.4%, 140/1126), ST17 (4.8%, 54/1126), and ST651 (3.7%, 42/1126). GBS was highly resistant to tetracycline (75.1% [95% CI 74.0-76.3%]) and erythromycin (65.4% [95% CI 64.5-66.3%]) and generally susceptible to penicillin, ampicillin, vancomycin, ceftriaxone, and linezolid. Resistance rates of GBS to clindamycin and levofloxacin varied greatly (1.0-99.2% and 10.3-72.9%, respectively). A summary analysis of the bacterial drug resistance reports released by the China Antimicrobial Resistance Surveillance System (CARSS) in the past 5 years showed that the drug resistance rate of GBS to erythromycin, clindamycin, and levofloxacin decreased slowly from 2018 to 2020. However, the resistance rates of GBS to all 3 antibiotics increased slightly in 2021.. The overall colonization rate in China was much lower than the global colonization rate (17.4%). Consistent with many original and review reports in other parts of the world, GBS was highly resistant to tetracycline. However, the resistance of GBS isolates in China to erythromycin and clindamycin was greater than in other countries. This paper provides important epidemiological information, to assist with prevention and treatment of GBS colonization in these women.

Topics: Anti-Bacterial Agents; China; Clindamycin; Drug Resistance, Bacterial; Erythromycin; Female; Humans; Levofloxacin; Microbial Sensitivity Tests; Multilocus Sequence Typing; Pregnancy; Streptococcal Infections; Streptococcus agalactiae; Tetracycline

Streptococcus uberis is one of the most common pathogens associated with bovine mastitis, commonly treated with antimicrobials (AM), favoring the appearance of antimicrobial resistance (AMR). The objective of this work was to determine the proportion of phenotypic AMR among S. uberis isolated worldwide from bovine intramammary infections between the years 1983-2022, and to assess the variables associated by means of a systematic review and metanalysis. Sixty articles were eligible for quantitative review. Ninety-four independent studies were obtained. The antimicrobials evaluated in more S. uberis strains were penicillin (21,987 strains), oxacillin (21,727 strains), erythromycin (20,013 strains), and ampicillin (19,354 strains). Most of the studies included in this meta-analysis were from Europe (44), followed by America (25), Africa (10), Asia (10), and Oceania (5). Among the included articles, 22 were published from 1983 to 2006, 23 from 2007 to 2012, 25 from 2013 to 2015, and the remaining 24 after 2016. Penicillin, erythromycin, and tetracycline were the antimicrobials with >25 studies. Therefore, the following analyses were performed only for these antimicrobials, presenting a high heterogeneity index (I

Topics: Animals; Anti-Bacterial Agents; Anti-Infective Agents; Cattle; Cattle Diseases; Drug Resistance, Bacterial; Erythromycin; Female; Mastitis, Bovine; Microbial Sensitivity Tests; Penicillins; Streptococcal Infections; Tetracycline

Maternal rectovaginal colonization with Streptococcus agalactiae (Group B Streptococcus or GBS) is the most common route for the GBS disease in the perinatal period. The knowledge of maternal colonization, antibiotic resistance and serotype profiles is substantially needed to formulate the broad vaccine. However, it has not been estimated in Africa. This meta-analysis was aimed to determine the pooled prevalence of colonization, antibiotic resistance and serotype profiles of GBS reported in Africa.. Potentially relevant studies from 1989 to 31th January, 2019 were retrieved from the Medline/PubMed, EMBASE, HINARI online databases, periodicals and by requesting authors. Unpublished studies retrieved from grey literature through Google and Google Scholar. Pooled estimates were calculated using the random effect model. Subgroup analysis was done to investigate the burden of colonization across sub-regions, sampling site and countries. Summary estimates were presented using words, Forest plots and Tables. Heterogeneity was assessed using the I. Eighty-three articles were assessed, of which 57 studies conducted in five sub-regions with 21 countries (22,206 pregnant women) met pre-specified inclusion criteria. The overall estimate of recto-vaginal colonization was 19.3% (95% CI 16.9, 21.7). The highest estimate was observed in Southern Africa, 23.8% (95% CI 18.7, 28.9), followed by Northern Africa, 22.7% (95% CI 18.2, 27.2) while the lowest was driven from the Eastern Africa, 15.4% (95% CI 12.1, 18.7). Considerable heterogeneity across and within regions, sampling site, screening methods and countries (I. The pooled estimate of the maternal colonization with GBS was 19.3% which is equivalent with other many primary and review reports worldwide. The most antibiotic resistance estimate was recorded in the tetracycline followed by penicillin. Five serotypes were the most prevalent in Africa and more data on the antibiotic résistance and serotype distribution patterns are needed from developing countries to devise the effective preventive measures. In addition, the antibiotic susceptibility test methods used in the Africa shall be assessed for its quality. Trial registration Prospero Registration Number CRD42018094525.

Topics: Ampicillin; Anti-Bacterial Agents; Ceftriaxone; Clindamycin; Drug Resistance, Bacterial; Erythromycin; Female; Humans; Pregnancy; Pregnancy Complications, Infectious; Serogroup; Streptococcal Infections; Streptococcus agalactiae; Tetracycline; Vancomycin

Anaerobic bacteria were isolated from the subdural space in all four cases of subdural empyema encountered over a 2 and a half year period. Only one aerobe was isolated in these cases. The bacteriology of subdural empyema was further analyzed from a review of 327 cases reported in the English literature. Anaerobes accounted for 12 per cent of 234 cases; In addition, 27 per cent of cases were reportedly "sterile." These data support our finding that anaerobic bacteria may play a far more important role in subdural empyema than was previously appreciated.

Topics: Adolescent; Ampicillin; Anaerobiosis; Bacteroides; Bacteroides Infections; Brain Abscess; Child; Chloramphenicol; Clindamycin; Dexamethasone; Drainage; Female; Humans; Male; Meninges; Methicillin; Middle Aged; Penicillins; Peptostreptococcus; Pneumococcal Infections; Staphylococcal Infections; Staphylococcus; Streptococcal Infections; Streptococcus; Streptococcus pneumoniae; Subdural Space; Tetracycline

Topics: Animals; Anti-Bacterial Agents; Bacterial Infections; Carbenicillin; Chloramphenicol; Drug Antagonism; Drug Combinations; Drug Synergism; Drug Therapy, Combination; Folic Acid Antagonists; Humans; Kanamycin; Meningitis; Microbial Sensitivity Tests; Penicillin Resistance; Penicillins; Streptococcal Infections; Streptomycin; Sulfonamides; Tetracycline; Vancomycin

Topics: Adult; Anti-Bacterial Agents; Cephalosporins; Child; Chloramphenicol; Erythromycin; Escherichia coli Infections; Gentamicins; Humans; Infant; Klebsiella Infections; Microbial Sensitivity Tests; Neomycin; Otorhinolaryngologic Diseases; Penicillins; Pneumococcal Infections; Pseudomonas aeruginosa; Pseudomonas Infections; Streptococcal Infections; Streptomycin; Sulfonamides; Tetracycline; Tracheoesophageal Fistula

Topics: Adolescent; Adult; Aminosalicylic Acids; Bronchitis; Child; Child, Preschool; Erythromycin; Female; Haemophilus Infections; Herpesviridae Infections; Humans; Infant; Isoniazid; Male; Mycoplasma Infections; Penicillins; Pneumococcal Infections; Pneumonia; Pneumonia, Pneumocystis; Pneumonia, Staphylococcal; Pneumonia, Viral; Radiography; Respiratory Tract Infections; Skin Tests; Streptococcal Infections; Tetracycline; Tuberculosis, Pulmonary

Topics: Abscess; Adolescent; Adult; Aged; Ampicillin; Bacteriological Techniques; Bacteroides; Bacteroides Infections; Child; Child, Preschool; DNA, Bacterial; Drainage; Female; Gingiva; Humans; Infant; Injections; Male; Methylphenidate; Microbial Sensitivity Tests; Middle Aged; Penicillin Resistance; Penicillins; Postoperative Complications; Streptococcal Infections; Substance-Related Disorders; Suppuration; Tetracycline

Topics: Aminoglycosides; Ampicillin; Anti-Infective Agents; Antifungal Agents; Antitubercular Agents; Antiviral Agents; Bronchitis; Cephalosporins; Chloramphenicol; Drug Combinations; Humans; Lincomycin; Meningococcal Infections; Penicillin G; Penicillin Resistance; Penicillins; Pneumococcal Infections; Streptococcal Infections; Sulfamethoxazole; Sulfonamides; Tetracycline; Trimethoprim; Urinary Tract Infections

Topics: Acute Disease; Child; Child, Preschool; Chlorpheniramine; Chronic Disease; Ear, Middle; Enterobacteriaceae Infections; Gentamicins; Haemophilus Infections; Humans; Infant; Methicillin; Otitis Media; Recurrence; Streptococcal Infections; Tetracycline; Tympanic Membrane

Topics: Actinomycetales Infections; Bacterial Infections; Bacteroides Infections; Chloramphenicol; Diagnostic Techniques, Surgical; Drainage; Fusobacterium; Humans; Lincomycin; Liver Abscess; Penicillins; Radionuclide Imaging; Streptococcal Infections; Tetracycline

Topics: Ampicillin; Anti-Bacterial Agents; Deodorants; Erythromycin; Humans; Penicillin G; Penicillin G Benzathine; Penicillin G Procaine; Penicillin Resistance; Penicillins; Skin Diseases; Soaps; Streptococcal Infections; Tetracycline

Topics: Aged; Arteriosclerosis; Cell Wall; Cryptococcus; Edetic Acid; Endocarditis, Bacterial; Escherichia coli; Haemophilus Infections; Humans; Immunity, Cellular; L Forms; Lysostaphin; Male; Penicillins; Protoplasts; Salmonella; Sepsis; Spheroplasts; Stomatitis; Streptococcal Infections; Tetracycline; Thrombophlebitis; Urinary Tract Infections; Whipple Disease

Topics: Acute Disease; Ampicillin; Animals; Anti-Bacterial Agents; Chloramphenicol; Chronic Disease; Corynebacterium; Disease Models, Animal; Dogs; Escherichia coli Infections; Gentamicins; Haplorhini; Kidney; Ligation; Mice; Nalidixic Acid; Nitrofurantoin; Penicillin G; Proteus Infections; Pseudomonas Infections; Pyelonephritis; Rabbits; Rats; Staphylococcal Infections; Streptococcal Infections; Streptomycin; Sulfonamides; Tetracycline; Ureter

Topics: Chloramphenicol; Colistin; Dihydrostreptomycin Sulfate; Drug Synergism; Endocarditis, Subacute Bacterial; Hearing Disorders; Humans; Kanamycin; Penicillin Resistance; Penicillins; Polymyxins; Sepsis; Streptococcal Infections; Streptomycin; Tetracycline; Vestibulocochlear Nerve

Topics: Acinetobacter Infections; Anti-Bacterial Agents; Antifungal Agents; Clostridium Infections; Corynebacterium; Drug Synergism; Enteritis; Erythromycin; Escherichia coli Infections; Female; Humans; Infections; Mycobacterium Infections; Mycoses; Neomycin; Penicillins; Respiratory Tract Infections; Staphylococcal Infections; Streptococcal Infections; Streptomycin; Tetracycline; Vaginitis

Topics: Acute Disease; Anti-Bacterial Agents; Bacitracin; Bronchitis; Chloramphenicol; Chronic Disease; Ear Diseases; Humans; Labyrinth Diseases; Laryngitis; Neomycin; Novobiocin; Otitis Externa; Otitis Media; Penicillins; Pneumococcal Infections; Polymyxins; Respiratory Tract Infections; Staphylococcal Infections; Streptococcal Infections; Streptomycin; Tetracycline; Tonsillitis; Tracheal Diseases

Topics: Anti-Bacterial Agents; Cephalosporins; Chloramphenicol; Colistin; Drug Hypersensitivity; Enterobacteriaceae Infections; Erythromycin; Female; Gonorrhea; Humans; Kidney Diseases; Mycoplasma Infections; Pelvic Inflammatory Disease; Salpingitis; Staphylococcal Infections; Streptococcal Infections; Streptomycin; Tetracycline; Thrombophlebitis; Tuberculosis, Female Genital; Wound Infection

Topics: Bacteriological Techniques; Diagnosis; Embolism; Endocarditis, Bacterial; Erythromycin; Fever; Heart Defects, Congenital; Heart Valves; Humans; Lung Diseases; Penicillin Resistance; Penicillins; Pneumococcal Infections; Postoperative Complications; Prognosis; Sepsis; Staphylococcal Infections; Streptococcal Infections; Streptomycin; Tetracycline; Vancomycin

Neonatal Group B streptococcal infections may not respond to antimicrobial therapy and have been associated with case fatality rates of 50 per cent or greater. We evaluated the effect on colonization and disease rates of a single intramuscular dose of aqueous penicillin G given at birth in a prospectively controlled study of 18,738 neonates during a 25-month period. The colonization rate in the mothers was 26.6 per cent, with 50 per cent concordance in the untreated infants and 12.2 per cent in the penicillin-treated infants (P < 0.001). There was a significant decrease in the incidence of disease caused by all penicillin-susceptible organisms in the penicillin group (0.64 vs. 2.26 cases per thousand live births, P = 0.005). Disease caused by penicillin-resistant pathogens was increased in the penicillin-treated group during the first year of the study but was unaffected during the second year. Routine administration of parenteral penicillin at birth cannot be recommended until the effect on the incidence of disease caused by penicillin-resistant pathogens is fully defined.

Topics: Bacteria; Bacterial Infections; Clinical Trials as Topic; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meningitis; Penicillin G; Penicillin Resistance; Penicillins; Prospective Studies; Streptococcal Infections; Streptococcus agalactiae; Tetracycline

Topics: Ampicillin; Anti-Bacterial Agents; Candida; Child, Preschool; Chronic Disease; Erythromycin; Exudates and Transudates; Haemophilus Infections; Haemophilus influenzae; Humans; Micrococcus; Neisseria; Otitis Media; Penicillin Resistance; Penicillins; Placebos; Retrospective Studies; Staphylococcal Infections; Streptococcal Infections; Sulfonamides; Tetracycline; Time Factors; Tympanic Membrane

The incidence of early- and late-onset sepsis and meningitis in neonates due to maternal rectovaginal group B. Seventy-five GBS isolates collected from pregnant Korean women visiting Wonju Severance Christian Hospital, Wonju, Korea between 2017 and 2019 were subjected to WGS using the NovaSeq 6000 system (Illumina, San Diego, CA, USA). Multilocus sequence types, serotypes, antimicrobial resistance genes, and hemolysin operon mutations were determined by WGS, and the latter three were compared with the results of conventional phenotypic methods.. The predominant lineage was CC1 (37.3%), followed by CC19 (32.0%), CC12 (17.3%), and CC17 (4.0%). All isolates were cps typeable (100%, (75/75), and 89.3% of cps genotypes (67/75) were concordant with serotypes obtained using latex agglutination. The cps genotypes of the 75 isolates were serotypes III (24.0%), V (22.7%), and VIII (17.3%). All isolates harboring intact. The low prevalence of CC17 GBS colonization may explain the low frequency of neonatal GBS infections. WGS is a useful tool for simultaneous genotyping and antimicrobial resistance determination.

Topics: Anti-Bacterial Agents; Erythromycin; Female; Hemolysin Proteins; Humans; Infant, Newborn; Multilocus Sequence Typing; Pregnancy; Pregnant Women; Streptococcal Infections; Streptococcus agalactiae; Tetracycline; Virulence Factors

Streptococcus agalctiae (Group B Streptococcus, GBS) is a perinatal pathogen and a leading cause of neonatal infections worldwide. Serotype, sequence type, clonality, antibiotic resistance genes and surface protein profiles of GBS are scarce in Ethiopia, a reason that this study was planned to investigate. .. Sixteen colonizing GBS isolates obtained from recto-vaginal swabs of pregnant women and body surfaces of newborns were further analyzed. Minimum inhibitory concentration (MIC) test, and whole genome sequence (WGS) methods were done for antibiotic susceptibility test, and molecular characterization of the isolates.. All the GBS isolates analyzed were belonged to four capsular serotypes: II, 11/16(68.8%), V, 3/16(18.8%), Ia and VI each with 1/16(6.3%) and five sequence type (ST-2, ST-10, ST-14, ST-569 and ST-933). Sequence type-10 was the most predominant ST followed by ST-569. The five STs were grouped into the four clonal complexes (CC - 1, CC-10, CC-19, and CC-23). Different surface proteins and pili families such as ALP1, ALPHA, ALP23, PI-1 / PI-2A1, PI-1 / PI-2B, and Srr1 were detected from WGS data. All isolates were found to be susceptible to the tested antibiotics except for tetracycline in MIC and WGS test methods used. Tetracycline resistant determinant genes such as TETM and TETL / TETM combination were identified.. Further studies on serotype and molecular epidemiology will provide a comprehensive data of the GBS capsular serotype and clones available in Ethiopia.

Topics: Anti-Bacterial Agents; Drug Resistance, Bacterial; Ethiopia; Female; Hospitals, Special; Hospitals, University; Humans; Infant, Newborn; Microbial Sensitivity Tests; Molecular Epidemiology; Phylogeny; Pregnancy; Pregnancy Complications, Infectious; Prevalence; Rectum; Serogroup; Streptococcal Infections; Streptococcus agalactiae; Tetracycline; Vagina; Whole Genome Sequencing

This study assessed whether Streptococcus agalactiae isolates from companion animals differed from those of human origin. Beta-hemolytic S. agalactiae was collected from a veterinary laboratory center and a university hospital. Strains were identified using 16S rRNA amplicon sequencing and amplification of the species-specific dltS gene. We conducted virulence gene profiling, capsular genotyping, determination of clonal complex (CC), and antimicrobial resistance (AMR) phenotyping or genotyping. The 20 non-invasive isolates obtained from animals and 15 non-invasive isolates from adult humans were comparatively analyzed in this study. We found significant differences in the virulence gene profiles of bca-rib-lmb-cylE (40.0% vs. 93.3%) and the possession of bac (30.0% vs. 0%) between animal-origin and human-origin non-invasive strains. We observed a significant difference in the distribution of CC1 between the two non-invasive populations. There were significant differences in the prevalence of tetracycline resistance genotypes (60.0% vs. 20.0%) and absence of AMR genotypes (30.0% vs. 80.0%), and AMR rates of tetracycline (35.0% vs. 0%) and fluoroquinolone (20.0% vs. 66.7%) between the two non-invasive populations. These observations suggest that there were different features, in terms of virulence gene profile, CC, and AMR genotype/phenotype in the non-invasive isolates of animal origin compared to those of human origin.

Topics: Adult; Animals; Anti-Bacterial Agents; Cat Diseases; Cats; Dog Diseases; Dogs; Drug Resistance, Bacterial; Female; Genotype; Hospitals, University; Humans; Japan; Laboratory Animal Science; Male; Pets; Phenotype; Streptococcal Infections; Streptococcus agalactiae; Tetracycline; Virulence

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Child; Child, Preschool; Drug Resistance, Bacterial; Erythromycin; Female; Genotype; Humans; Infant; Lebanon; Male; Microbial Sensitivity Tests; Middle Aged; Molecular Epidemiology; Streptococcal Infections; Streptococcus pyogenes; Tetracycline; Young Adult

Group B Streptococcus (GBS) is a leading cause of early-onset disease (EOD) and late-onset disease (LOD) in infants. We sought to investigate the antibiotic susceptibility profiles, resistance genes, virulence-related genes, serotype distribution and genotypic characteristics of GBS recovered from infected or colonized neonates and pregnant women in a tertiary teaching hospital in Shenzhen, China, from 2008 to 2015.. High resistance rates of erythromycin (66.7-100%) were detected among early-onset GBS (EOGBS), late-onset GBS (LOGBS), neonatal colonizing GBS (NCGBS) and maternal colonizing GBS (MCGBS). 89.5-100% of four groups of GBS isolates showed resistance to tetracycline. More than 90 % of erythromycin resistant isolates of EOGBS (8/8, 100%), LOGBS (16/17, 94.1%) and NCGBS (10/11, 90.9%) harbored ermB, while only 9.1-17.6% harbored mefA/E. By contrast, 55.8% (24/43) and 62.8% (27/43) of erythromycin resistant MCGBS isolates carried ermB and mefA/E genes, respectively. The tetO gene was more common in tetracycline resistant EOGBS (10/11, 90.9%), LOGBS (17/17, 100%) and NCGBS (10/11, 90.9%), compared to tetracycline resistant MCGBS (12/51, 23.5%). Additionally, the tetM gene accounted for 90.9% (10/11), 76.5% (13/17), 45.5% (5/11) and 80.4% (41/51) of four groups of isolates, respectively. Serotype III was the most predominant in EOGBS (8/12, 66.7%) and LOGBS (15/17, 88.2%), while serotype Ib accounted for 50.0% (6/12) of NCGBS, and serotype Ia and III accounted for 45.6% (26/57) and 33.3% (19/57) of MCGBS, respectively. Sequence type 17 (ST17) was the most common in EOGBS (6/12, 50%) and LOGBS (12/17, 70.6%), while ST12 was predominant in NCGBS (5/12, 41.7%), and five STs (ST19, ST23, ST12, ST103 and ST485) accounted for 66.7% (38/57) of the MCGBS. All serotype III-ST17 isolates recovered from neonates were associated with invasive infections.. This study shows the meaningful differences in molecular mechanisms of resistance to erythromycin and tetracycline, and the prevalence of serotypes and STs among GBS recovered from neonates and pregnant women. ST17 is predominant in neonatal invasive GBS, but rare in NCGBS and MCGBS.

Topics: Adult; Anti-Bacterial Agents; Bacterial Proteins; China; Drug Resistance, Multiple, Bacterial; Erythromycin; Female; Follow-Up Studies; Genotype; Humans; Infant; Infant, Newborn; Male; Microbial Sensitivity Tests; Multilocus Sequence Typing; Phenotype; Phylogeny; Pregnancy; Pregnancy Complications, Infectious; Streptococcal Infections; Streptococcus agalactiae; Tetracycline; Young Adult

Topics: Adolescent; Adult; Anti-Bacterial Agents; Brazil; Carrier State; Child; Child, Preschool; Drug Resistance, Bacterial; Female; Humans; Macrolides; Male; Pharyngitis; Pharynx; Prospective Studies; Streptococcal Infections; Streptococcus; Tetracycline; Young Adult

Streptococcus gallolyticus subspecies (subsp.) pasteurianus, previously known as Streptococcus bovis biotype II/2, has been described as a causative agent of endocarditis, neonatal sepsis, meningitis, bacteremia, and colorectal carcinoma in humans. The aim of this study was to characterize the erythromycin and tetracycline resistance genes of S. gallolyticus subsp. pasteurianus strains isolated from patients with septicemia and bacteremia in Thailand.. The clinical isolates of Streptococcus gallolyticus were identified by using conventional biochemical tests, PCR, and sodA gene sequence analysis. The erythromycin and tetracycline susceptibilities were determined by disk diffusion and agar dilution methods, while the resistance genes were identified by nucleotide sequence analysis.. From a total of 108 blood cultures, 36 (33%) were identified as S. gallolyticus subsp. pasteurianus with the nucleotide sequence identities of partial sodA gene with the reference strains ranging from 98.1 to 100%. Of these, 25 (69.4%) contained erythromycin resistance genes and erm(B) was the most predominant gene (30.6%), followed by erm(T) (19.4%) and mef(A) (5.6%). In addition, erm(B) was also detected in combination with lnu(B) (8.3%), erm(T) and mef(A) (2.8%), and mef(A) and lnu(B) (2.8%). It was interesting to note that lnu(B) was detected for the first time in S. gallolyticus subsp. pasteurianus in this study. For tetracycline resistance genes, tet(L) and tet(M) were detected at 13.9% and 11.1%, respectively. However, tet(M) in combination with tet(L) was detected most commonly at 69.4% and with tet(L) and tet(O) at 5.6%.. A number of erythromycin and tetracycline resistance genes were detected in S. gallolyticus subsp. pasteurianus strains circulating in Thailand.

Topics: Anti-Bacterial Agents; Bacteremia; Erythromycin; Humans; Microbial Sensitivity Tests; Models, Statistical; Multigene Family; Phylogeny; Polymerase Chain Reaction; Sepsis; Streptococcal Infections; Streptococcus gallolyticus; Tetracycline; Tetracycline Resistance; Thailand

This paper describes for the first time the isolation of Streptococcus lutetiensis in a cat with intestinal lymphoma. The Streptococcus bovis group has undergone significant taxonomic changes over the past two decades and, in 2002, Poyart et al. described two distinct novel species within the genus Streptococcus: Streptococcus lutetiensis and Streptococcus pasteurianus. The bovis group streptococci include commensal species and subspecies or opportunistic pathogens of humans and animals. The cat was referred to the Veterinary Teaching Hospital, University of Bologna for chronic diarrhoea associated with fresh blood. A diagnosis of intestinal lymphoma was advanced. S. lutetiensis was accidentally isolated from the faeces of the cat and identified through MALDI-TOF and 16s rRNA sequencing. The Kirby-Bauer test revealed that the isolate was resistant to enrofloxacin, erythromycin, clindamycin, marbofloxacin and tetracycline. The detection of S. lutetiensis in cat faeces might suggest that it could be a normal inhabitant of cat intestinal tract or that it could be involved in the manifestation of intestinal diseases. Since bacteria belonging to the S. bovis group are considered emerging pathogens, additional research is required to evaluate the role of S. lutetiensis in cats and its role in the transmission of antimicrobial resistance. SIGNIFICANCE AND IMPACT OF THE STUDY: In this study the isolation of Streptococcus lutetiensis from a cat with intestinal lymphoma was described for the first time. An antimicrobial susceptibility test performed by means of the disc diffusion method revealed that the isolate was resistant to enrofloxacin, erythromycin, clindamycin, marbofloxacin and tetracycline. Nowadays the ecological or pathogenetic role of S. lutetiensis in the gut of animals remains unclear but, even if its role as commensal bacterium was confirmed, the presence of multi-resistant S. lutetiensis in cat gut could favour the transmission of antimicrobial resistance to other bacteria.

Topics: Animals; Anti-Bacterial Agents; Cat Diseases; Cats; Clindamycin; Diarrhea; Disk Diffusion Antimicrobial Tests; Drug Resistance, Multiple, Bacterial; Erythromycin; Feces; Female; Fluoroquinolones; Intestinal Neoplasms; Intestines; Lymphoma; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; Streptococcal Infections; Streptococcus; Tetracycline

To estimate the prevalence of antibiotic resistance in indicator bacteria Escherichia coli and Enterococci isolated from duck faeces in Morogoro Municipality, Tanzania.. Escherichia coli and Enterococcus isolation rates from ducks faeces were 91 and 100% respectively. The prevalence of antibiotic resistance of E. coli and Enterococcus was 70.3 and 42%, respectively. E. coli resistant to four antibiotics were 28 (30.8%) and showed high resistance to ampicillin (81.3), tetracycline (75.8) and trimethoprim-sulphamethoxine (62.3). Multiple antibiotic resistance of Enterococcus were more than 65%. High resistance rates shown by Enterococcus were observed in rifampin (62%), ampicillin (62%) and tetracycline (42%). Almost all farmers (92.3%) left their ducks to scavenge for food around their houses. Antibiotics used in animal treatments were oxytetracyclines, sulfonamides, penicillin dihydrostreptomycin while in humans were tetracycline, ampicillin, and amoxicillin.

Topics: Ampicillin; Animals; Anti-Bacterial Agents; Asymptomatic Diseases; Drug Resistance, Multiple, Bacterial; Ducks; Enterococcus; Escherichia coli; Escherichia coli Infections; Feces; Female; Humans; Male; Microbial Sensitivity Tests; Poultry; Poultry Diseases; Rifampin; Streptococcal Infections; Tanzania; Tetracycline; Trimethoprim, Sulfamethoxazole Drug Combination

In Serbia, the frequency of macrolide-resistant group A streptococci (MRGASs) increased significantly from 2006 to 2009. MRGAS analysis in 2008 revealed the presence of three major clonal lineages: emm75/mefA, emm12/mefA, and emm77/ermTR. The aim of the present study was to determine the prevalence of macrolide resistance and to evaluate variations in the clonal composition of MRGASs. The study included 1,040 pharyngeal group A streptococci collected throughout Serbia, which were tested for antimicrobial susceptibility. MRGAS isolates were further characterized by the presence of resistance determinants, emm typing, and pulsed-field gel electrophoresis analysis. The prevalence of macrolide resistance was 9.6%, showing a slight decrease compared with the rate of 12.5% (2008). Tetracycline resistance was present in 6% of isolates, while norfloxacin nonsusceptibility detected for the first time in Serbia was 9.8%. The M phenotype dominated (84%), followed by the constitutive macrolides, lincosamides, and streptogramin B phenotype (12%). Five emm types were detected: emm75, emm12, emm1, emm28, and emm89. The emm75/mefA (62%), emm12/mefA (14%), and emm12/ermB/tetM (6%) were predominant clones and were found in both the present and the previous study periods at different frequencies. The major change was the loss of emm77/ermTR/tetO, which contributed to 15% of MRGASs in 2008.

Topics: Adolescent; Anti-Bacterial Agents; Child; Child, Preschool; Clonal Evolution; Drug Resistance, Bacterial; Female; Genes, Bacterial; Genotype; Humans; Lincosamides; Macrolides; Male; Microbial Sensitivity Tests; Phenotype; Serbia; Streptococcal Infections; Streptococcus; Tetracycline

The collaboration project VASIB aims at reducing the antibiotic consumption in pig production by integrating information from consulting expertise in clinical inspection, hygiene, epidemiology, microbiology and pharmacology. In this VASIB subproject, we investigated the antimicrobial susceptibility and relatedness of porcine respiratory tract pathogens. Bordetella bronchiseptica (n = 47), Pasteurella multocida (n = 18) and Streptococcus suis (n = 58) were obtained from weaner pigs at two farms. Antimicrobial susceptibility testing was performed by broth microdilution according to CLSI standards. Resistance genes were detected via specific PCR assays. Macrorestriction analysis was conducted to determine the relatedness of the isolates and to identify clones. The B. bronchiseptica isolates showed indistinguishable (farm 1) or two closely related XbaI-patterns (farm 2). Different SmaI-PFGE patterns of P. multocida isolates were obtained at three different time points. In contrast, PFGE analysis of S. suis indicated more than one fragment pattern per pig and time point. Isolates exhibiting indistinguishable PFGE patterns were considered to represent the same clone. This study showed that only two closely related B. bronchiseptica clones were present in both farms, which had low MICs to all antimicrobials, except to β-lactams. Different P. multocida clones were present at the three time points. They showed overall low MIC values, with two clones being resistant and one intermediate to tetracycline. S. suis clones were resistant to tetracycline (n = 19) and/or erythromycin/clindamycin (n = 16). They harboured the tetracycline resistance genes tet(O), tet(M) or tet(L) and/or the macrolide/lincosamide/streptogramin B resistance gene erm(B). Five penicillin-resistant S. suis clones were also detected.

Topics: Animals; Anti-Infective Agents; Bacteria; beta-Lactams; Bordetella bronchiseptica; Bordetella Infections; Drug Resistance, Multiple, Bacterial; Lincosamides; Macrolides; Microbial Sensitivity Tests; Pasteurella Infections; Pasteurella multocida; Respiratory Tract Infections; Streptococcal Infections; Streptococcus suis; Swine; Swine Diseases; Tetracycline; Weaning

The group B Streptococcus (GBS) is a human commensal bacterium, which is capable of causing several infectious diseases in infants, and people with chronic diseases. GBS has been the most common cause of infections in urinary tract of the elders, but relatively few studies reported the urine-isolated GBS and their antimicrobial susceptibilities. Hence, we decided to investigate GBS specially isolated from urine in Suzhou, China.. 27 GBS samples were isolated from urine in Suzhou, China. The PCR and agarose gel electrophoresis were used to identify the serotype distribution. Susceptibility tests were based on MIC test and Kirby-Bauer test. Genome were sequenced via Illumina Hiseq platform and assembled by SPAdes. Genomes of five isolates were sequenced and submitted to NCBI genome database. The sequencing files in fastq format were submitted to NCBI SRA database.. Five serotypes were identified. The resistant rates measured for tetracycline, erythromycin, clindamycin and fluoroquinolones were 74.1, 63.0, 44.4 and 48.1%, respectively. 18.5% of the isolates were nonsusceptible to nitrofurantoin. The resistance to tetracycline was mainly associated with the gene tetM. The erythromycin resistance was mainly associated with the genes ermB and mefE. The genes ermB and lnuB were the prevalent genes in cMLSB type. No known nitrofurantoin resistance gene was found in nitrofurantoin-nonsusceptible GBS.. Five serotypes were identified in our study. High rates of GBS isolates were resistant to tetracycline, erythromycin, clindamycin and fluoroquinolones. The genes ermB and lnuB occupied high rates in cMLS

Topics: Anti-Bacterial Agents; Base Sequence; China; Clindamycin; Disk Diffusion Antimicrobial Tests; DNA, Bacterial; Erythromycin; Fluoroquinolones; Genome, Bacterial; Humans; Nitrofurantoin; Sequence Analysis, DNA; Streptococcal Infections; Streptococcus agalactiae; Tetracycline

Streptococcus suis is a major zoonotic pathogen that causes severe disease in both humans and pigs. Australia's pig herd has been quarantined for over 30 years, however S. suis remains a significant cause of disease. In this study, we investigated S. suis from 148 cases of clinical disease in pigs from 46 pig herds over a period of seven years, to determine the level of genetic difference from international isolates that may have arisen over the 30 years of separation. Isolates underwent whole genome sequencing, genome analysis and antimicrobial susceptibility testing. Data was compared at the core genome level to clinical isolates from overseas. Results demonstrated five predominant multi-locus sequence types and two major cps gene types (cps2 and 3). At the core genome level Australian isolates clustered predominantly within one large clade consisting of isolates from the UK, Canada and North America. A small proportion of Australian swine isolates (5%) were phylogenetically associated with south-east Asian and UK isolates, many of which were classified as causing systemic disease, and derived from cases of human and swine disease. Based on this dataset we provide a comprehensive outline of the current S. suis clones associated with disease in Australian pigs and their global context, with the main finding being that, despite three decades of separation, Australian S. suis are genomically similar to overseas strains. In addition, we show that ST1 clones carry a constellation of putative virulence genes not present in other Australian STs.

Topics: Animals; Anti-Bacterial Agents; Australia; Drug Resistance, Multiple, Bacterial; Erythromycin; Genome, Bacterial; Genomics; Humans; Multilocus Sequence Typing; Phylogeny; Streptococcal Infections; Streptococcus suis; Swine; Swine Diseases; Tetracycline; Viral Proteins; Virulence; Virulence Factors

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.. 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.. The carriage of β-hemolytic streptococci was detected in 18.1% of participants, with. The present study demonstrated significant throat carriage of GAS and the presence of group C streptococci (

Topics: Adolescent; Anti-Bacterial Agents; Argentina; Carrier State; Child; Child, Preschool; Drug Resistance, Bacterial; Female; Humans; Macrolides; Male; Microbial Sensitivity Tests; Pharyngitis; Pharynx; Phenotype; Rural Population; Streptococcal Infections; Streptococcus pyogenes; Tetracycline

The aim of this study was to investigate the antibacterial resistance of Streptococcus pyogenes (GAS), and correlate the findings with the sales of erythromycin and tetracycline. General practitioners in the Faroe Islands were recruited to send oropharyngeal swabs. From an ongoing pneumococcal study, nasopharyngeal swabs were sampled from healthy children 0-7 years of age. Erythromycin susceptibility data from Iceland were obtained from the reference laboratory at the Landspitali University Hospital. Susceptibility testing in the Faroe Islands and Iceland was performed according to CLSI methods and criteria. The resistance rate to erythromycin and tetracycline found in patients in the Faroe Islands in 2009/2010 was 6% and 30% respectively. Tetracycline resistance in patients declined significantly from 2009 to 2010 (37-10%, p-value = 0.006 < 0.05) and differed significantly between age groups (p-value = 0.03 < 0.05). In Iceland, there was a peak in erythromycin resistance in 2008 (44%) and a substantial decrease in 2009 (5%). Although the prevalence of erythromycin and tetracycline resistance in the Faroe Islands and Iceland may be associated with antimicrobial use, sudden changes can occur with the introduction of new resistant clones.

Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Asymptomatic Diseases; Child; Child, Preschool; Denmark; Drug Resistance, Bacterial; Erythromycin; Female; Humans; Iceland; Infant; Infant, Newborn; Male; Microbial Sensitivity Tests; Middle Aged; Oropharynx; Streptococcal Infections; Streptococcus pyogenes; Tetracycline; Tonsillitis

A significant proportion of group B Streptococcus (GBS) neonatal disease, particularly late-onset disease, is associated with strains of serotype III, clonal complex (CC) 17. CC17 strains also cause invasive infections in adults. Little is known about the phylogenetic relationships of isolates recovered from neonatal and adult CC17 invasive infections. We performed whole-genome-based phylogenetic analysis of 93 temporally and geographically matched CC17 strains isolated from both neonatal and adult invasive infections in the metropolitan region of Toronto/Peel, Canada. We also mined the whole-genome data to reveal mobile genetic elements carrying antimicrobial resistance genes. We discovered that CC17 GBS strains causing neonatal and adult invasive disease are interspersed and cluster tightly in a phylogenetic tree, signifying that they are derived from the same genetic pool. We identified limited variation due to recombination in the core CC17 genome. We describe that loss of Pilus Island 1 and acquisition of different mobile genetic elements carrying determinants of antimicrobial resistance contribute to CC17 genetic diversity. Acquisition of some of these mobile genetic elements appears to correlate with clonal expansion of the strains that possess them. Our results provide a genome-wide portrait of the population structure and evolution of a major disease-causing clone of an opportunistic pathogen.

Topics: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Canada; Child; DNA, Bacterial; Drug Resistance, Bacterial; Genome, Bacterial; Humans; Infant; Infant, Newborn; Middle Aged; Phylogeny; Polymorphism, Single Nucleotide; Sequence Analysis, DNA; Serogroup; Streptococcal Infections; Streptococcus agalactiae; Tetracycline

Macrolides are often used to treat group A streptococcus (GAS) infections, but their resistance rates reached high proportions worldwide. The aim of the present study was to give an update on the characteristics and contemporary prevalence of macrolide-resistant pharyngeal GAS in Central Italy. A total of 592 isolates causing pharyngitis in children were collected in the period 2012-2013. Clonality was assessed by emm typing and pulsed-field gel electrophoresis (PFGE) for all macrolide-resistant strains and for selected susceptible isolates. Genetic determinants of resistance were screened by polymerase chain reaction (PCR). Forty-four GAS were erythromycin-resistant (7.4 %). Among them, 52.3 % and 50 % were clindamycin- and tetracycline-resistant, respectively. erm(B)-positive isolates (52.3 %) expressed the constitutive cMLSB phenotype. mef(A) and its associated M phenotype were recorded in 40.9 % of the cases. The remaining erm(A)-positive isolates expressed the iMLSB phenotype. Seventeen tetracycline-resistant isolates carried tet(M) and five isolates carried tet(O). Twenty-five emm types were found among all strains, with the predominance of emm types 12, 89, 1, and 4. Eleven emm types and 12 PFGE clusters characterized macrolide-resistant strains, with almost two-thirds belonging to emm12, emm4, and emm11. Macrolide-susceptible and -resistant emm types 12, 89, 11, and 4 shared related PFGE profiles. There was a dramatic decline in macrolide resistance in Central Italy among pharyngeal GAS isolates in 2012-2013 when compared to previous studies from the same region (p < 0.05), although macrolide consumption remained stable over the past 15 years. We observed a decrease in the proportion of macrolide-resistant strains within emm types commonly associated with macrolide resistance in the past, namely emm12, 1, and 89.

Topics: Adolescent; Anti-Bacterial Agents; Child; Child, Preschool; Clindamycin; Drug Resistance, Bacterial; Erythromycin; Female; Humans; Italy; Male; Microbial Sensitivity Tests; Pharyngitis; Streptococcal Infections; Streptococcus pyogenes; Tetracycline

Streptococcus agalactiae (GBS) has been implicated in urinary tract infections but the microbiological characteristics and antimicrobial susceptibility of these strains are poorly investigated. In this study, 87 isolates recovered from urine samples of patients who had attended the Spedali Civili of Brescia (Italy) and had single organism GBS cultured were submitted to antimicrobial susceptibility testing, molecular characterization of macrolide and levofloxacin resistance, PCR-based capsular typing and analysis of surface protein genes. By automated broth microdilution method, all isolates were susceptible to penicillin, cefuroxime, cefaclor, and ceftriaxone; 80%, 19.5% and 3.4% of isolates were non-susceptible to tetracycline, erythromycin, and levofloxacin, respectively. Macrolide resistance determinants were iMLS(B) (n=1), cMLS(B) (n=10) and M (n=5), associated with ermTR, ermB and mefA/E. Levofloxacin resistance was linked to mutations in gyrA and parC genes. Predominant capsular types were III, Ia, V, Ib and IX. Type III was associated with tetracycline resistance, while type Ib was associated with levofloxacin resistance. Different capsular type-surface protein gene combinations (serotype V-alp2, 3; serotype III-rib; serotype Ia-epsilon) were detected. A variety of capsular types are involved in significant bacteriuria. The emergence of multidrug resistant GBS may become a significant public health concern and highlights the importance of careful surveillance to prevent the emergence of these virulent GBS.

Topics: Anti-Bacterial Agents; Cefaclor; Ceftriaxone; Cefuroxime; Disk Diffusion Antimicrobial Tests; DNA Gyrase; Drug Resistance, Bacterial; Erythromycin; Humans; Levofloxacin; Penicillins; Streptococcal Infections; Streptococcus agalactiae; Tetracycline; Urinary Tract Infections

A nationwide laboratory-based surveillance study of invasive S. pyogenes infections was conducted in Germany. Invasive isolates (n = 1,281) were obtained between 2003 and 2013. All isolates were susceptible to penicillin, cefotaxime and vancomycin. Tetracycline showed the highest rate of resistant or intermediate resistant isolates with 9.8%, followed by macrolides (4.0%), trimethoprim/sulfamethoxazole (SXT) (1.9%), levofloxacin (1.3%), chloramphenicol (0.9%) and clindamycin (0.7%). The most prominent trends were the appearance of levofloxacin non-susceptible isolates since 2011, and an increase of SXT non-susceptibility since 2012.

Topics: Anti-Bacterial Agents; Cefotaxime; Chloramphenicol; Clindamycin; Epidemiological Monitoring; Germany; Humans; Levofloxacin; Macrolides; Microbial Sensitivity Tests; Penicillins; Streptococcal Infections; Streptococcus pyogenes; Tetracycline; Trimethoprim, Sulfamethoxazole Drug Combination; Vancomycin

Resistant pathogens are an increasing threat affecting millions of people globally. More complicated patients are presented with pathogens harboring new resistance mechanisms, while the pipeline of new antimicrobials hardly proposes solutions. In such a scenario, more severely ill patients remain with no adequate treatment to offer. In addition, massive misuse of antimicrobials, including excessive length of treatment or wrong dosage, also contributes to increasing the rate of pathogens resistance to antimicrobials. Isolation of Streptococcus pyogenes (Group A Streptococcus-GAS) is the main indication for antibiotic treatment to patients diagnosed with acute tonsillitis. Hence, GAS resistance to antibiotics requires periodic monitoring.. To assess susceptibility rates of GAS to penicillin, macrolides, clindamycin, and tetracycline in northern Israel and to compare the findings to the high antimicrobial susceptibility of GAS isolates reported in the same region in 2004 and to other geographical areas.. Throat samples from 300 outpatients were collected and cultured at the regional laboratory of Emek Medical Center during September to October 2011.. In 300 samples, the susceptibility rates of GAS to penicillin, erythromycin, azithromycin, clindamycin, and tetracycline in northern Israel still remain very high.. Continuous control of antimicrobials usage and periodic surveillance of susceptibility rates, together with educational programs and appropriate and targeted treatment protocols, are essential and highly recommended to keep these high susceptibility rates for as long as possible.

Topics: Anti-Bacterial Agents; Azithromycin; Child; Clindamycin; Drug Resistance, Bacterial; Epidemiological Monitoring; Erythromycin; Female; Humans; Israel; Male; Microbial Sensitivity Tests; Penicillins; Streptococcal Infections; Streptococcus pyogenes; Tetracycline; Tonsillitis; Young Adult

To investigate the distribution of erythromycin, tetracycline and chloramphenicol resistance mechanisms and determinants and the relevant genetic environments and elements in viridans group streptococci (VGS).. A total of 263 VGS collected from routine throat swabs in 2010-12 and identified to the species level were studied. Antibiotic resistance determinants and the relevant genetic contexts and elements were determined using amplification and sequencing assays and restriction analysis.. The investigation provided original information on the distribution of resistance mechanisms, determinants and genetic elements in VGS. Erythromycin-resistant isolates totalled 148 (56.3%; 37 belonging to the cMLS phenotype and 111 belonging to the M phenotype); there were 72 (27.4%) and 7 (2.7%) tetracycline- and chloramphenicol-resistant isolates, respectively. A number of variants of known genetic contexts and elements carrying determinants of resistance to these antibiotics were detected, including the mega element, Φ10394.4, Tn2009, Tn2010, the IQ element, Tn917, Tn3872, Tn6002, Tn916, Tn5801, a tet(O) fragment from ICE2096-RD.2 and ICESp23FST81.. These findings shed new light on the distribution of antibiotic resistance mechanisms and determinants and their genetic environments in VGS, for which very few such data are currently available. The high frequency and broad variety of such elements supports the notion that VGS may be important reservoirs of resistance genes for the more pathogenic streptococci. The high rates of macrolide resistance confirm the persistence of a marked prevalence of resistant VGS in Europe, where macrolide resistance is, conversely, declining among the major streptococcal pathogens.

Topics: Anti-Bacterial Agents; Chloramphenicol; DNA, Bacterial; Drug Resistance, Bacterial; Erythromycin; Humans; Italy; Molecular Sequence Data; Pharynx; Polymerase Chain Reaction; Sequence Analysis, DNA; Streptococcal Infections; Tetracycline; Viridans Streptococci

Beta-hemolytic streptococci (βHS) cause a diverse array of human infections. Despite the high number of cases of streptococcal carriers and diseases, studies discerning the molecular epidemiology of βHS in India are limited. This study reports the molecular and clinical epidemiology of beta-hemolytic streptococcal infections from two geographically distinct regions of India.. A total of 186 isolates of βHS from north and south India were included. The isolates were identified to species level and subjected to antimicrobial susceptibility testing. Polymerase chain reaction (PCR) was done to detect exotoxin genes, and emm types of group A streptococci (GAS) strains were ascertained by sequencing.. GAS was the most common isolate (71.5%), followed by group G streptococci (GGS) (21%). A large proportion of GAS produced speB (97%), smeZ (89%), speF (91%), and speG (84%). SmeZ was produced by 21% and 50% of GGS and GGS, respectively. A total of 45 different emm types/subtypes were seen in GAS, with emm 11 being the most common. Resistance to tetracycline (73%) and erythromycin (34.5%) was commonly seen in GAS.. A high diversity of emm types was seen in Indian GAS isolates with high macrolide and tetracycline resistance. SpeA was less commonly seen in Indian GAS isolates. There was no association between disease severity and exotoxin gene production.

Topics: Anti-Bacterial Agents; Antigens, Bacterial; Bacterial Outer Membrane Proteins; Carrier Proteins; Drug Resistance, Bacterial; Genetic Variation; Hemolysin Proteins; Humans; India; Macrolides; Molecular Epidemiology; Polymerase Chain Reaction; Sequence Analysis, DNA; Streptococcal Infections; Streptococcus; Tetracycline

Group B Streptococcus (GBS) remains a major cause of neonatal sepsis and is also associated with invasive and noninvasive infections in pregnant women and non-pregnant adults, elderly and patients with underlying medical conditions. Ten capsular serotypes have been recognized, and determination of their distribution within a specific population or geographical region is important as they are major targets for the development of vaccine strategies. We have evaluated the characteristics of GBS isolates recovered from individuals with infections or colonization by this microorganism, living in different geographic regions of Brazil.. A total of 434 isolates were identified and serotyped by conventional phenotypic tests. The determination of antimicrobial susceptibility was performed by the disk diffusion method. Genes associated with resistance to erythromycin (ermA, ermB, mefA) and tetracycline (tetK, tetL, tetM, tetO) as well as virulence-associated genes (bac, bca, lmb, scpB) were investigated using PCR. Pulsed-field gel electrophoresis (PFGE) was used to examine the genetic diversity of macrolide-resistant and of a number of selected macrolide-susceptible isolates.. Overall, serotypes Ia (27.6%), II (19.1%), Ib (18.7%) and V (13.6%) were the most predominant, followed by serotypes IV (8.1%) and III (6.7%). All the isolates were susceptible to the beta-lactam antimicrobials tested and 97% were resistant to tetracycline. Resistance to erythromycin and clindamycin were found in 4.1% and 3% of the isolates, respectively. Among the resistance genes investigated, tetM (99.3%) and tetO (1.8%) were detected among tetracycline-resistant isolates and ermA (39%) and ermB (27.6%) were found among macrolide-resistant isolates. The lmb and scpB virulence genes were detected in all isolates, while bac and bca were detected in 57 (13.1%) and 237 (54.6%) isolates, respectively. Molecular typing by PFGE showed that resistance to erythromycin was associated with a variety of clones.. These findings indicate that GBS isolates circulating in Brazil have a variety of phenotypic and genotypic characteristics, and suggest that macrolide-resistant isolates may arise by both clonal spread and independent acquisition of resistance genes.

Topics: Adult; Aged; Anti-Bacterial Agents; Bacterial Proteins; Brazil; Clindamycin; Drug Resistance, Multiple, Bacterial; Erythromycin; Female; Genetic Variation; Genotype; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Molecular Sequence Data; Phylogeny; Pregnancy; Pregnancy Complications; Serotyping; Streptococcal Infections; Streptococcus agalactiae; Tetracycline; Virulence; Virulence Factors

Group B streptococcus (GBS) is a commensal bacterium of the human gastrointestinal and genital tracts. It is a leading cause of neonatal sepsis and meningitis, and has also been recognized as an important pathogen in pregnant women and the elderly. We investigated mechanisms of macrolide and tetracycline resistance in GBS colonizing women in Egypt. A total of 100 isolates were screened using standard antibiotic susceptibility tests. A multiplex PCR assay was used to detect macrolide- and tetracycline-resistance determinants. All isolates were uniformly susceptible to penicillin G, ampicillin, cefotaxime, vancomycin and levofloxacin. The resistance rates to erythromycin, clindamycin, azithromycin, tetracycline and chloramphenicol were 17, 14, 16, 98 and 1 %, respectively. Among the erythromycin-resistant isolates, 82.4 % had constitutive macrolide-lincosamide-streptogramin B (cMLSB) resistance, 5.9 % had inducible MLSB (iMLSB) resistance and 11.8 % had M phenotype resistance. Among the cMLSB phenotypes, 64.3 % of isolates harboured the ermB gene and 35.7 % of isolates harboured none of the investigated macrolide-resistance genes. The single strain expressing the iMLSB phenotype possessed the ermA gene. Of the two strains with the M phenotype, only one possessed the mefA/E gene. Conversely, seven macrolide-sensitive strains (MIC <0.03 µg ml(-1)) were ermB positive and one macrolide-sensitive strain (MIC <0.03 µg ml(-1)) harboured mefA/E. Tetracycline resistance was predominantly due to tetM, which was detected alone (83.7 %) or in association with tetL (12.2 %), tetK (1 %) or tetO (1 %). One strain carried tetM associated with both tetL and tetK, and another strain carried tetO alone. The tetO strains were positive for the mefA/E gene, and the tetL and tetK carrier strains harboured the ermB gene. Susceptible strains harbouring but not expressing an antibiotic-resistance gene should be regarded as potentially resistant. These results emphasize the need to monitor the epidemiology of GBS antibiotic resistance in Egypt.

Topics: Anti-Bacterial Agents; DNA, Bacterial; Drug Resistance, Bacterial; Egypt; Female; Genes, Bacterial; Humans; Macrolides; Microbial Sensitivity Tests; Molecular Epidemiology; Multiplex Polymerase Chain Reaction; Pregnancy; Pregnancy Complications, Infectious; Streptococcal Infections; Streptococcus agalactiae; Tetracycline

Streptococcus agalactiae (Group B Streptococcus, GBS) is a commensal of the digestive and genitourinary tracts of humans that emerged as the leading cause of bacterial neonatal infections in Europe and North America during the 1960s. Due to the lack of epidemiological and genomic data, the reasons for this emergence are unknown. Here we show by comparative genome analysis and phylogenetic reconstruction of 229 isolates that the rise of human GBS infections corresponds to the selection and worldwide dissemination of only a few clones. The parallel expansion of the clones is preceded by the insertion of integrative and conjugative elements conferring tetracycline resistance (TcR). Thus, we propose that the use of tetracycline from 1948 onwards led in humans to the complete replacement of a diverse GBS population by only few TcR clones particularly well adapted to their host, causing the observed emergence of GBS diseases in neonates.

Topics: Anti-Bacterial Agents; Base Sequence; Clone Cells; DNA Transposable Elements; Europe; Genes, Bacterial; Genome, Bacterial; High-Throughput Nucleotide Sequencing; Humans; Molecular Sequence Data; North America; Phylogeny; Polymorphism, Single Nucleotide; Selection, Genetic; Streptococcal Infections; Streptococcus agalactiae; Tetracycline; Tetracycline Resistance

Streptococcus agalactiae (GBS) is a major source of human perinatal diseases and bovine mastitis. Erythromycin (Ery) and tetracycline (Tet) are usually employed for preventing human and bovine infections although resistance to such agents has become common among GBS strains. Ery and Tet resistance genes are usually carried by conjugative transposons (CTns) belonging to the Tn916 family, but their presence and transferability among GBS strains have not been totally explored. Here we evaluated the presence of Tet resistance genes (tetM and tetO) and CTns among Ery-resistant (Ery-R) and Ery-susceptible (Ery-S) GBS strains isolated from human and bovine sources; and analyzed the ability for transferring resistance determinants between strains from both origins. Tet resistance and int-Tn genes were more common among Ery-R when compared to Ery-S isolates. Conjugative transfer of all resistance genes detected among the GBS strains included in this study (ermA, ermB, mef, tetM and tetO), in frequencies between 1.10(-7) and 9.10(-7), was possible from bovine donor strains to human recipient strain, but not the other way around. This is, to our knowledge, the first report of in vitro conjugation of Ery and Tet resistance genes among GBS strains recovered from different hosts.

Topics: Animals; Anti-Bacterial Agents; Cattle; Conjugation, Genetic; DNA Transposable Elements; Drug Resistance, Bacterial; Erythromycin; Gene Transfer Techniques; Humans; Streptococcal Infections; Streptococcus agalactiae; Tetracycline

Analysis of data on the occurrence of severe infections caused by group A streptococci, emm typing of the isolated strains, and survey of resistance to the selected antibiotics.. In 2012 and 2013, 43 S. pyogenes strains were isolated from severe infections. The isolates were most often recovered from wounds and abscesses (36 patients), followed by blood culture (5 patients), sputum (1 patient), and autopsy samples (1 patient). Antimicrobial susceptibility to selected antibiotics ( penicillin, erythromycin, clindamycin, spiramycin, and tetracycline) was tested by the disk-diffusion method and the minimal inhibitory concentrations (MICs) were determined.. In 2012 and 2013, an increase in severe streptococcal infections was observed, with 27 and 16 cases reported, respectively. Resistance to macrolides was detected in 18.5% and 12.5% of isolates, respectively, and resistance to tetracycline in 25.9% and 20% of isolates, respectively. The isolated S. pyogenes strains were most often assigned to emm type 1. Risk factors for streptococcal infection were analyzed, with injury being most often identified as a risk factor- in seven and two patients, respectively. The patients were most frequently treated by beta-lactam antibiotics (penicillin and ampicillin). In 2012, two cases were fatal.. This study reports cases of invasive group A streptococcal (GAS) infection as seen in clinical practice. An increased occurrence of S. pyogenes was observed in the hospital, with the isolates exhibiting elevated resistance to erythromycin and tetracycline. It is necessary to monitor the trends of antimicrobial resistance and the distribution of emm types among group A streptococcal isolates. Cooperation of the laboratory and clinical professionals in the prevention and therapy of streptococcal infections, invasive in particular, is crucial for risk reduction.

Topics: Adult; Aged; Aged, 80 and over; Ampicillin; Anti-Bacterial Agents; Drug Resistance, Bacterial; Erythromycin; Female; Humans; Macrolides; Male; Microbial Sensitivity Tests; Middle Aged; Penicillins; Streptococcal Infections; Streptococcus pyogenes; Tetracycline; Young Adult

Camels are the most valuable livestock species in the Horn of Africa and play a pivotal role in the nutritional sustainability for millions of people. Their health status is therefore of utmost importance for the people living in this region. Streptococcus agalactiae, a Group B Streptococcus (GBS), is an important camel pathogen. Here we present the first epidemiological study based on genetic and phenotypic data from African camel derived GBS. Ninety-two GBS were characterized using multilocus sequence typing (MLST), capsular polysaccharide typing and in vitro antimicrobial susceptibility testing. We analysed the GBS using Bayesian linkage, phylogenetic and minimum spanning tree analyses and compared them with human GBS from East Africa in order to investigate the level of genetic exchange between GBS populations in the region. Camel GBS sequence types (STs) were distinct from other STs reported so far. We mapped specific STs and capsular types to major disease complexes caused by GBS. Widespread resistance (34%) to tetracycline was associated with acquisition of the tetM gene that is carried on a Tn916-like element, and observed primarily among GBS isolated from mastitis. The presence of tetM within different MLST clades suggests acquisition on multiple occasions. Wound infections and mastitis in camels associated with GBS are widespread and should ideally be treated with antimicrobials other than tetracycline in East Africa.

Topics: Animals; Anti-Bacterial Agents; Bacterial Proteins; Camelus; Genetic Variation; Humans; Kenya; Multilocus Sequence Typing; Phylogeny; Polymerase Chain Reaction; Streptococcal Infections; Streptococcus agalactiae; Tetracycline; Tetracycline Resistance

Streptococcus suis serotype 2 is known to cause severe infections in pigs, including meningitis, endocarditis and pneumonia. Furthermore, this bacterium is considered an emerging zoonotic agent. Recently, increased antibiotic resistance in S. suis has been reported worldwide. The objective of this study was to evaluate the potential of nisin, a bacteriocin of the lantibiotic class, as an antibacterial agent against the pathogen S. suis serotype 2. In addition, the synergistic activity of nisin in combination with conventional antibiotics was assessed. Using a plate assay, the nisin-producing strain Lactococcus lactis ATCC 11454 proved to be capable of inhibiting the growth of S. suis (n=18) belonging to either sequence type (ST)1, ST25, or ST28. In a microdilution broth assay, the minimum inhibitory concentration (MIC) of purified nisin ranged between 1.25 and 5 μg/mL while the minimum bactericidal concentration (MBC) was between 5 and 10 μg/mL toward S. suis. The use of a capsule-deficient mutant of S. suis indicated that the presence of this polysaccharidic structure has no marked impact on susceptibility to nisin. Following treatment of S. suis with nisin, transmission electron microscopy observations revealed lysis of bacteria resulting from breakdown of the cell membrane. A time-killing curve showed a rapid bactericidal activity of nisin. Lastly, synergistic effects of nisin were observed in combination with several antibiotics, including penicillin, amoxicillin, tetracycline, streptomycin and ceftiofur. This study brought clear evidence supporting the potential of nisin for the prevention and treatment of S. suis infections in pigs.

Topics: Amoxicillin; Animals; Anti-Bacterial Agents; Bacterial Capsules; Bacterial Typing Techniques; Cell Membrane; Cephalosporins; Drug Combinations; Drug Resistance, Microbial; Drug Synergism; Lactococcus lactis; Microbial Sensitivity Tests; Microscopy, Electron, Transmission; Nisin; Penicillins; Streptococcal Infections; Streptococcus suis; Streptomycin; Swine; Swine Diseases; Tetracycline

A total of 146 group B streptococcus isolates from 8 cities across China belonged to four serotypes. Serotype Ia was more common in children. A high prevalence of resistance was observed for levofloxacin (37.7%), erythromycin (71.2%), clindamycin, (53.4%), and tetracycline (81.5%). The levofloxacin and clindamycin resistances among the 4 serotypes differed significantly. Eighty percent of fluoroquinolone-resistant isolates belonged to the sequence type 19 (ST19)/serotype III clone, with GyrA-ParC-ParE triple substitutions. This clone carried the erm(B), mef(E), and tet(M) genes.

Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; China; Clindamycin; DNA Gyrase; DNA Topoisomerase IV; Drug Resistance, Bacterial; Erythromycin; Genes, Bacterial; Humans; Levofloxacin; Middle Aged; Mutation; Ofloxacin; Prevalence; Serotyping; Streptococcal Infections; Streptococcus agalactiae; Tetracycline

A total of 143 group B streptococcus (GBS) isolates collected from mothers at the Maternity Hospital in Kuwait were investigated for their serotypes and antibiotic resistance, and screened by PCR for the carriage of genes for resistance to tetracycline (tetk, tetM, tetL, tetO), erythromycin (ermA, ermB, ermC, ermTR, ermM, mefA, mefE, msrA) and aminoglycosides (aph3, ant4, ant6). All isolates were serotyped using a latex agglutination test. Most of the isolates belonged to serotypes V (38.5 %), III (20.9 %), Ia (7.7 %) and II (11.2 %). Sixteen isolates (11.2 %) were nontypable. All isolates were susceptible to penicillin, ampicillin and cefotaxime (MICs 0.016-0.094 µg ml(-1)) but were resistant to trimethoprim (92.3 %), tetracycline (89.5 %), minocycline (89.5 %), high-level kanamycin (76.9 %), chloramphenicol (30.0 %), erythromycin (12.6 %), clindamycin (7.0 %), high-level streptomycin (3.5 %) and ciprofloxacin (0.7 %). The tetracycline-resistant isolates contained tetM (94.5 %), tetO (3.9 %), tetL (1.6 %) and tetK (0.8 %). The erythromycin-resistant isolates contained ermB (61.1 %), ermTR (38.9 %), ermA (5.5 %), mefA (5.5 %) and mefE (11 %). All high-level kanamycin-resistant isolates contained aph3. One of the high-level streptomycin-resistant isolates contained ant6. Partial DNA sequencing of aph3 revealed sequences with 99 % similarity to aph3 found in Enterococcus faecium, Enterococcus faecalis, Staphylococcus aureus and Staphylococcus epidermidis, suggesting that the GBS isolates could have acquired aph3 from other Gram-positive cocci. The high proportion of isolates with resistance to tetracycline, high-level kanamycin and trimethoprim, and the increase in the prevalence of erythromycin resistance, represents an emerging public health concern that needs further surveillance.

Topics: Adult; Aminoglycosides; Anti-Bacterial Agents; Bacterial Proteins; Drug Resistance, Bacterial; Erythromycin; Female; Hospitals, Maternity; Humans; Infant, Newborn; Kuwait; Microbial Sensitivity Tests; Polymerase Chain Reaction; Sequence Analysis, DNA; Serotyping; Streptococcal Infections; Streptococcus agalactiae; Tetracycline

In ICESp2905, a widespread erm(TR)- and tet(O)-carrying genetic element of Streptococcus pyogenes, the two resistance determinants are contained in separate fragments inserted into a scaffold of clostridial origin. ICESp2905 (∼65.6 kb) was transferable not only in its regular form but also in a defective form lacking the erm(TR) fragment (ICESp2906, ∼53.0 kb). The erm(TR) fragment was also an independent integrative and conjugative element (ICE) (ICESp2907, ∼12.6 kb). ICESp2905 thus results from one ICE (ICESp2907) being integrated into another (ICESp2906).

Topics: Anti-Bacterial Agents; Base Sequence; Chromosome Mapping; Chromosomes, Bacterial; Conjugation, Genetic; DNA, Bacterial; DNA, Circular; Erythromycin; Genes, Bacterial; Humans; Microbial Sensitivity Tests; Molecular Sequence Data; Open Reading Frames; Sequence Analysis, DNA; Streptococcal Infections; Streptococcus pyogenes; Tetracycline; Tetracycline Resistance

Between 2007 and 2009, 226 clinical strains of Streptococcus agalactiae, recovered from female genital specimens and from gastric fluid or ear specimens from infected newborns, were isolated at the Laboratory of Microbiology of Charles Nicolle Hospital of Tunis. They were investigated to determine the prevalence of antibiotic resistance and to characterize the mechanisms of resistance to macrolide and tetracycline. All strains were susceptible to penicillin, ampicillin and quinupristin-dalfopristin. They were resistant to chloramphenicol (3.1%), rifampicin (19.1%), erythromycin (40%) and tetracycline (97.3%); 3.1% were highly resistant to streptomycin and 1.3% to gentamicin. Among the erythromycin-resistant isolates, 78.7% showed a constitutive macrolide-lincosamide-streptogramin B (MLS(B)) phenotype with high-level resistance to macrolides and clindamycin (MIC(50) >256 µg ml(-1)), 10% showed an inducible MLS(B) phenotype with high MICs of macrolides (MIC(50) >256 µg ml(-1)) and low MICs of clindamycin (MIC(50)=8 µg ml(-1)) and 2.2% showed an M phenotype with a low erythromycin-resistance level (MIC range=12-32 µg ml(-1)) and low MICs of clindamycin (MIC range: 0.75-1 µg ml(-1)). All strains were susceptible to quinupristin-dalfopristin and linezolid (MIC(90): 0.75 µg ml(-1) for each). MLS(B) phenotypes were genotypically confirmed by the presence of the erm(B) gene and the M phenotype by the mef(A) gene. Resistance to tetracycline was mainly due to the tet(M) gene (93.1%) encoding a ribosome protection mechanism. This determinant is commonly associated with the conjugative transposon Tn916 (P≤0.0002). tet(O) and tet(T) existed in a minority (2.2% and 0.4%, respectively). The efflux mechanism presented by tet(L) was less frequently present (4.5%). No significant association was found between erm(B) and tet(M) genes.

Topics: Anti-Bacterial Agents; Drug Resistance, Bacterial; Ear; Female; Gastric Juice; Genes, Bacterial; Genitalia, Female; Genotype; Humans; Infant, Newborn; Macrolides; Microbial Sensitivity Tests; Phenotype; Polymerase Chain Reaction; Streptococcal Infections; Streptococcus agalactiae; Tetracycline; Tunisia

We report retrospective analysis of the clinical and antimicrobial susceptibility data of 140 Streptococcus pseudopneumoniae isolates. Strains were isolated mostly from respiratory tract samples from patients with underlying diseases. In the case of infection, pneumonia, mainly aspiration pneumonia, was the most frequent (27.1% of the patients). We documented high rates of decreased susceptibilities and resistance to erythromycin and tetracycline (57% and 43% of the isolates, respectively), as well as reduced susceptibility to penicillin in 21% of the isolates.

Topics: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Bronchoalveolar Lavage Fluid; Child; Erythromycin; Female; France; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Penicillins; Pneumonia, Bacterial; Respiratory Tract Infections; Retrospective Studies; Sputum; Streptococcal Infections; Streptococcus; Tetracycline; Young Adult

Group A Streptococcus (GAS) causes human diseases ranging in severity from uncomplicated pharyngitis to life-threatening necrotizing fasciitis and shows high rates of macrolide resistance in several countries. Our goal is to identify antimicrobial resistance in Spanish GAS isolates collected between 1994 and 2006 and to determine the molecular epidemiology (emm/T typing and PFGE) and resistance mechanisms of those resistant to erythromycin and tetracycline.. Two hundred ninety-five out of 898 isolates (32.8%) were erythromycin resistant, with the predominance of emm4T4, emm75T25, and emm28T28, accounting the 67.1% of the 21 emm/T types. Spread of emm4T4, emm75T25 and emm28T28 resistant clones caused high rates of macrolide resistance. The distribution of the phenotypes was M (76.9%), cMLSB (20.3%), iMLSB (2.7%) with the involvement of the erythromycin resistance genes mef(A) (89.5%), msr(D) (81.7%), erm(B) (37.3%) and erm(A) (35.9%).Sixty-one isolates were tetracycline resistant, with the main representation of the emm77T28 among 20 emm/T types. To note, the combination of tet(M) and tet(O) tetracycline resistance genes were similar to tet(M) alone reaching values close to 40%. Resistance to both antibiotics was detected in 19 isolates of 7 emm/T types, being emm11T11 and the cMLSB phenotype the most frequent ones. erm(B) and tet(M) were present in almost all the strains, while erm(A), mef(A), msr(D) and tet(O) appeared in less than half of them.. Spanish GAS were highly resistant to macrolides meanwhile showed minor resistance rate to tetracycline. A remarkable correlation between antimicrobial resistance and emm/T type was noticed. Clonal spread of emm4T4, emm75T25 and emm28T28 was the main responsable for macrolide resistance where as that emm77T28 clones were it to tetraclycline resistance. A wide variety of macrolide resistance genes were responsible for three macrolide resistance phenotypes.

Topics: Anti-Bacterial Agents; Antigens, Bacterial; Bacterial Outer Membrane Proteins; Carrier Proteins; Cluster Analysis; DNA, Bacterial; Drug Resistance, Bacterial; Electrophoresis, Gel, Pulsed-Field; Erythromycin; Humans; Microbial Sensitivity Tests; Molecular Epidemiology; Molecular Typing; Spain; Streptococcal Infections; Streptococcus pyogenes; Tetracycline

To analyze the characteristics of antibiotic resistance on group A streptococcus isolated from pediatrics in Beijing in 2011, to provide reference for clinical drug administration.. Strains of group A streptococcus were collected from the Departments of Pediatrics in 36 hospitals at different Districts of Beijing, from May to July 2011. Minimal inhibitory concentrations (MIC) with ten antibiotics of these isolates were tested by VITEK 2 Compact method. All the Susceptibility rate (S%), Intermediate rate (I%) and Resistance rate (R%) were calculated according to their MIC values. The macrolides resistant phenotype of group A streptococcus was detected by D-test.. A total of 633 (19.1%) group A streptococcus strains were cultured from 3315 throat swabs. All the isolates were susceptible to penicillin, ampicillin, streptogramin, linezolid, tigecycline, vancomycin, while 96.5% (611/633) of the isolates were susceptible to levofloxacin. A total of the 96.1% (608/633) isolates exhibited resistance to erythromycin. The resistance rates to clindamycin and tetracycline were 79.3% (502/633) and 93.7% (593/633), respectively. A total of 9 different resistant patterns were observed, with the dominant patterns as:concomitant resistance to erythromycin, clindamycin and tetracycline (72.7%, 460/633), followed by combined resistance to erythromycin and tetracycline (18.0%, 114/633). The most commonly seen macrolide resistant phenotype was cMLS type (83.2%). In total, 97 strains belonged to iMLS type and 5 strains to M type. Data through multivariate logistic regression analysis showed that factors as occupation and samples being collected from the sub-urban areas etc. were significantly associated with the resistance rates to tetracycline and the odds ratio (95%CI) as 2.43 (1.16 - 5.09) and 2.35 (1.47 - 3.73). Isolates collected from the sub-urban areas were significantly associated with resistance rates to clindamycin, with the odds ratio (95%CI) being 0.48 (0.25 - 0.92).. All the isolates acquired from the Pediatrics Departments in Beijing were susceptible to penicillin and ampicillin. The high resistance rates of erythromycin, clindamycin and tetracycline resistance to group A streptococcus were observed, with the major resistant phenotype as cMLS. Factors as occupation and the collection site of samples were significantly associated with the resistance rates to tetracycline while the sites of sample collection were significantly associated with the resistance rates to clindamycin.

Topics: Adolescent; Child; Child, Preschool; China; Drug Resistance, Multiple, Bacterial; Female; Genotype; Humans; Male; Microbial Sensitivity Tests; Phenotype; Streptococcal Infections; Streptococcus pyogenes; Tetracycline

The genetic support for tet(W), an emerging tetracycline resistance determinant, was studied in two strains of Streptococcus suis, SsCA and SsUD, both isolated in Italy from patients with meningitis. Two completely different tet(W)-carrying genetic elements, sharing only a tet(W)-containing segment barely larger than the gene, were found in the two strains. The one from strain SsCA was nontransferable, and aside from an erm(B)-containing insertion, it closely resembled a genomic island recently described in an S. suis Chinese human isolate in sequence, organization, and chromosomal location. The tet(W)-carrying genetic element from strain SsUD was transferable (at a low frequency) and, though apparently noninducible following mitomycin C treatment, displayed a typical phage organization and was named ΦSsUD.1. Its full sequence was determined (60,711 bp), the highest BLASTN score being Streptococcus pyogenes Φm46.1. ΦSsUD.1 exhibited a unique combination of antibiotic and heavy metal resistance genes. Besides tet(W), it contained a MAS (macrolide-aminoglycoside-streptothricin) fragment with an erm(B) gene having a deleted leader peptide and a cadC/cadA cadmium efflux cassette. The MAS fragment closely resembled the one recently described in pneumococcal transposons Tn6003 and Tn1545. These resistance genes found in the ΦSsUD.1 phage scaffold differed from, but were in the same position as, cargo genes carried by other streptococcal phages. The chromosome integration site of ΦSsUD.1 was at the 3' end of a conserved tRNA uracil methyltransferase (rum) gene. This site, known to be an insertional hot spot for mobile elements in S. pyogenes, might play a similar role in S. suis.

Topics: Anti-Bacterial Agents; Bacterial Proteins; Conjugation, Genetic; DNA Transposable Elements; DNA, Bacterial; Genes, Bacterial; Humans; Microbial Sensitivity Tests; Molecular Sequence Data; Sequence Analysis, DNA; Streptococcal Infections; Streptococcus suis; Tetracycline; Tetracycline Resistance

A novel series of fully synthetic 8-azatetracyclines was prepared and evaluated for antibacterial activity. Compounds were identified that overcome both efflux (tet(K)) and ribosomal protection (tet(M)) tetracycline resistance mechanisms and are active against Gram-positive and Gram-negative organisms. Two compounds were identified that exhibit comparable efficacy to marketed tetracyclines in in vivo models of bacterial infection.

Topics: Administration, Oral; Animals; Anti-Bacterial Agents; Aza Compounds; Biological Availability; Escherichia coli Infections; Gram-Negative Bacteria; Gram-Positive Bacteria; Injections, Intravenous; Mice; Microbial Sensitivity Tests; Rats; Rats, Sprague-Dawley; Sepsis; Streptococcal Infections; Structure-Activity Relationship; Tetracycline Resistance; Tetracyclines

Topics: Adult; Aged; Anti-Bacterial Agents; Antigens, Bacterial; Bacterial Outer Membrane Proteins; Carrier Proteins; Electrophoresis, Gel, Pulsed-Field; Epidemics; Female; France; Humans; Ill-Housed Persons; Male; Microbial Sensitivity Tests; Middle Aged; Polymerase Chain Reaction; Streptococcal Infections; Streptococcus pyogenes; Tetracycline; Tetracycline Resistance; Young Adult

Streptococcus pyogenes or group A Streptococcus, a major human pathogen, remains susceptible to beta-lactams, but resistance to other antibiotics is becoming more common. The purpose of this study was to characterize both phenotypic and genotypic epidemiological markers of group A Streptococcus and to identify the mechanisms of resistance to macrolides and tetracyclines. A total of 103 strains, isolated at Charles Nicolle University Hospital of Tunis, were investigated. The rate of resistance to erythromycin was low (5%), whereas a high rate of tetracycline resistance was found (70%). All the macrolide-resistant isolates expressed the constitutive macrolide, lincosamide, and streptograminB phenotype and harbored the erm(B) gene. Resistance to tetracycline was mainly due to the tet(M) gene, which is commonly associated with the conjugative transposon Tn916. No significant association was found between erm(B) and tet(M) genes. The tetracycline-resistant strains belonged to 28 distinct emm types. Among them, emm118 was the most prevalent type, followed by emm42, std432, emm76, and emm18. However, emm1, emm4, emm6, emm28, and emm3 were the most frequent types among tetracycline susceptible isolates. Only emm118 and emm42 types (p ≤ 0.05) were significantly associated with resistance to tetracycline.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Bacterial Proteins; Child; Child, Preschool; Conjugation, Genetic; DNA Transposable Elements; Drug Resistance, Microbial; Genes, Bacterial; Humans; Macrolides; Microbial Sensitivity Tests; Middle Aged; Streptococcal Infections; Streptococcus pyogenes; Tetracycline; Tetracycline Resistance; Tunisia; Young Adult

During an area-based study, 75 group B streptococcus (GBS) strains isolated both from early-onset disease (EOD, 37 strains) and from late-onset disease (LOD, 38 strains) were analysed for serotype, pulsed field gel electrophoresis (PFGE) and multilocus sequence typing profiles, protein markers and antibiotic resistance. Serotype III, possessing the rib gene, was the most frequent (54 strains, 72%) and responsible for 89.5% and 54% of LOD and EOD, respectively. Forty-six serotype III strains belonged to the same PFGE type and clonal complex 17, already described as an over-represented clone in neonatal invasive GBS infections. Other serotypes were Ia (9.3%), II (6.7%), Ib (5.3%), V (5.3%) and IV (1.3%). Seventeen PFGE groups were identified comprising strains with related sequence types; conversely, strains displaying the same sequence type could belong to different PFGE groups. When both neonate and maternal strains from vaginorectal swabs and/or milk were available (eight cases), they were indistinguishable. Resistance to erythromycin (12%) was associated with a constitutive resistance to clindamycin in five cases (four carrying the erm(B) gene and one both the erm(B) and mef(E) genes) and with an inducible clindamycin resistance in two cases (one possessing the erm(A) gene, the other the erm(T) gene). Two isolates displayed the M phenotype (mef(E) gene). All strains but five were resistant to tetracycline, mostly mediated by the tet(M) gene (97.1%). The study underlined the importance of an active surveillance system for the elucidation of a GBS population structure causing neonatal infections and allowed the detection of rare antibiotic resistance determinants [erm(T)].

Topics: Anti-Bacterial Agents; Bacterial Proteins; Clindamycin; Cluster Analysis; DNA Fingerprinting; DNA, Bacterial; Drug Resistance, Bacterial; Electrophoresis, Gel, Pulsed-Field; Erythromycin; Genotype; Humans; Infant; Infant, Newborn; Italy; Microbial Sensitivity Tests; Molecular Epidemiology; Multilocus Sequence Typing; Phenotype; Proteome; Serotyping; Streptococcal Infections; Streptococcus agalactiae; Tetracycline

The aim of this study was to determine the prevalence and characteristics of non-fluoroquinolone (FQ)-susceptible Streptococcus pyogenes isolates and to study their mechanisms of resistance. We performed a prospective prevalence study with 468 isolates collected from 2005 to 2007 and a retrospective study that was based on the examination of existing data collected from 1999 to 2008. The retrospective study included data for isolates with high-level resistance (HR) to ciprofloxacin (MIC >or= 32 microg/ml) (HR isolates) and isolates with the same emm types as those reported in the literature with low-level resistance (LR) to ciprofloxacin (MICs, 2 to 8 microg/ml) (LR isolates, n = 205). Genetic characterization of the isolates was performed by means of emm typing and multilocus sequence typing. The prevalence of LR ranged from 1.9% in 2005 to 30.8% in 2007. This increase was mainly due to the circulation of an emm6 subtype (emm6.4) that represented 77.1% of the LR isolates in 2007. Notably, another emm6 subtype, also detected in 2007 (emm6.37), showed coresistance to 14- and 15-membered macrolides mediated by the mefA gene. Only three HR isolates were detected (isolates emm68.1/ST247/T3,13,B3264, emm77/ST399/T28, and emm28/ST52/T28), and all were identified in the retrospective study. Overall, the 673 isolates represented 25 emm types. All LR isolates were clustered into two emm types: emm6 (six emm6 subtypes) and emm75. All the 156 emm6 isolates had LR, harbored the Ser79/Ala mutation in the parC gene product, and had the same sequence type (ST), ST382. Most (21/33) of the emm75 isolates had LR, showed the Ser79/Phe plus Asp91/Asn double mutation in the parC gene product, and were ST150. The Asp91/Asn mutation by itself did not confer resistance to FQs.

Topics: Adult; Anti-Bacterial Agents; Child; Drug Resistance, Bacterial; Female; Fluoroquinolones; Genes, Bacterial; Humans; Male; Microbial Sensitivity Tests; Mutation; Prospective Studies; Spain; Streptococcal Infections; Streptococcus pyogenes

We describe 66 ciprofloxacin-nonsusceptible Streptococcus pyogenes isolates recovered from colonized and infected children. The ParC S79A substitution was frequent and associated with the emm6/sequence type 382 (emm6/ST382) lineage. The ParC D83G substitution was detected in two isolates (emm5/ST99 and emm28/ST52 lineages). One isolate (emm89/ST101) had no quinolone resistance-determining region codon substitutions or other resistance mechanisms. Five of 66 isolates were levofloxacin resistant. Although fluoroquinolones are not used in children, they may be putative disseminators of fluoroquinolone-nonsusceptible strains in the community.

Topics: Amino Acid Substitution; Anti-Bacterial Agents; Antigens, Bacterial; Bacterial Outer Membrane Proteins; Bacterial Typing Techniques; Carrier Proteins; Child; Ciprofloxacin; Drug Resistance, Bacterial; Humans; Molecular Epidemiology; Norfloxacin; Point Mutation; Portugal; Streptococcal Infections; Streptococcus pyogenes

The purpose of our study was to determine the prevalence of macrolide resistance in 3,188 pharyngeal Streptococcus pyogenes isolates collected at the Institute of Public Health of Serbia during the period 2006-2008. The disk diffusion tests were used to determine the susceptibility of the isolates. Two hundred and sixteen S. pyogenes isolates (6.8%) were resistant to erythromycin, with 9 isolates coresistant to tetracycline: 181 isolates harbored mefA gene, 19 ermB gene, 11 ermA(TR) gene, 5 ermB and mefA genes, and 7 tetM gene. Although the prevalence of macrolide resistance in pharyngeal S. pyogenes isolates is low in Serbia, monitoring of the emergence of resistance is advisable.

Topics: Anti-Bacterial Agents; Bacterial Proteins; DNA, Bacterial; Drug Resistance, Bacterial; Humans; Macrolides; Microbial Sensitivity Tests; Pharynx; Polymerase Chain Reaction; Prevalence; Serbia; Streptococcal Infections; Streptococcus pyogenes; Tetracycline

Bovine isolates of Streptococcus agalactiae (n = 76), Streptococcus dysgalactiae subsp. dysgalactiae (n = 32), and Streptococcus uberis (n = 101) were analyzed for the presence of different integrative and conjugative elements (ICEs) and their association with macrolide, lincosamide, and tetracycline resistance. The diversity of the isolates included in this study was demonstrated by multilocus sequence typing for S. agalactiae and pulsed-field gel electrophoresis for S. dysgalactiae and S. uberis. Most of the erythromycin-resistant strains carry an ermB gene. Five strains of S. uberis that are resistant to lincomycin but susceptible to erythromycin carry the lin(B) gene, and one has both linB and lnuD genes. In contrast to S. uberis, most of the S. agalactiae and S. dysgalactiae tetracycline-resistant isolates carry a tet(M) gene. A tet(S) gene was also detected in the three species. A Tn916-related element was detected in 30 to 50% of the tetracycline-resistant strains in the three species. Tetracycline resistance was successfully transferred by conjugation to an S. agalactiae strain. Most of the isolates carry an ICE integrated in the rplL gene. In addition, half of the S. agalactiae isolates have an ICE integrated in a tRNA lysine (tRNA(Lys)) gene. Such an element is also present in 20% of the isolates of S. dysgalactiae and S. uberis. A circular form of these ICEs was detected in all of the isolates tested, indicating that these genetic elements are mobile. These ICEs could thus also be a vehicle for horizontal gene transfer between streptococci of animal and/or human origin.

Topics: Animals; Anti-Bacterial Agents; Cattle; DNA Fingerprinting; Drug Resistance, Bacterial; Electrophoresis, Gel, Pulsed-Field; Genes, Bacterial; Genetic Variation; Genotype; Interspersed Repetitive Sequences; Lincosamides; Macrolides; Multilocus Sequence Typing; RNA, Bacterial; RNA, Transfer, Lys; Streptococcal Infections; Streptococcus; Tetracycline

The macrolide efflux mechanism of resistance, mef, was characterized in community-acquired respiratory tract infections with Streptococcus pyogenes. Fifty-four (4.6%) M phenotype isolates were screen tested as negative for mef(A). Of these 54 isolates, 5 (0.4%), 27 (2.3%), and 1 (0.1%) were considered to be mef(I) positive, a novel mosaic variant of mef, or a novel subclass of mef, respectively. This study shows (i) the definitive presence of mef(E) in S. pyogenes and its global distribution, (ii) the presence of a mosaic variant of mef composed of mef(A) and mef(E), (iii) the previously undescribed presence of mef(I) in S. pyogenes, and (iv) the presence of a novel subclass of mef in S. pyogenes.

Topics: Anti-Bacterial Agents; Bacterial Proteins; Community-Acquired Infections; Drug Resistance, Bacterial; Global Health; Humans; Macrolides; Membrane Proteins; Microbial Sensitivity Tests; Molecular Sequence Data; Population Surveillance; Respiratory Tract Infections; Sequence Analysis, DNA; Streptococcal Infections; Streptococcus pyogenes

Topics: Anti-Bacterial Agents; Bacterial Typing Techniques; Clindamycin; Erythromycin; Hong Kong; Hospitals; Humans; Microbial Sensitivity Tests; Serotyping; Streptococcal Infections; Streptococcus suis; Tetracycline

To determine the prevalence of Streptococcus suis and major pathogenic serotypes in middle part of Jiangsu province.. Tonsillar specimens from 303 slaughtered pigs aged 6 to 8 months were investigated for the presence of Streptococcus suis and major pathogenic serotypes by polymerase chain reaction (PCR) method. Bacteriological examination compared with molecular genetics identification for three Streptococcus suis isolates were also done.. The overall carrier rate of Streptococcus suis was up to 88.0%, with the percentages of serotype 1(14), 2(1/2), 7 and 9 were 9.6%, 8.5%, 11.3% and 29.5% respectively in 2005. While in 2006, the prevalence of Streptococcus suis was 82.5%, with capsular types 1 (14), 2 (1/2), 7 and 9 were accounted for 17.6%, 2.4%, 25.8% and 20.0% of all the specimens. All the three isolates belonged to Streptococcus suis serotype 2,named 2a, 2f and 14e, which exhibiting the virulent phenotype cps2+/gdh+/mrp-/lepf-/sly-/fbps+/orf2+/89k-, cps2+/lgdh+/mrp-/epf-/sly-/fbps-/orf2-/89k- and cps2+/gdh+/mrp-/epf-/sly-/fbps/orf2-/ respectively. These isolates were all susceptible to amoxicillin, ampicillin, penicillin and resistant to amikacin and tetraycline. Clinical signs were not noted in BALB/c mice and rabbit.. Prevalence of the Streptococcus suis among the healthy herds in the areas was very high, with various capsule types of Streptococcus suis involved in the same herds, and the virulent phenotype of these 3 isolates were very different from those prevalent Streptococcus suis serotype 2 virulent isolates frequently discovered from the epidemic areas.

Topics: Amikacin; Amoxicillin; Ampicillin; Animals; China; Mice; Mice, Inbred BALB C; Molecular Epidemiology; Penicillins; Polymerase Chain Reaction; Streptococcal Infections; Streptococcus suis; Tetracycline; Virulence

Available data from the Southern Reunion Island Medical Group was processed to assess the evolution of Streptococcus pneumoniae resistance to antibiotics since 1994 when the first penicillin-non-susceptible S. pneumoniae (PNSSP) was identified. In addition, 249 strains, isolated between 1998 and 2004, were tested against telithromycin and moxifloxacin.. Between 1994 and 2004, the percentage of PNSSP increased from 0 to 59.2%. Among PNSSP, 13.9% were resistant strains in 2004 with MICs<4 microg/ml. Before 2001 the rate of resistance to penicillin was superior to 50%. In 2004, 15.8 and 8.7% of the isolated strains were of decreased susceptibility to amoxicillin and cefotaxime respectively while none were resistant to either treatment. Other antibiotics followed the pattern of resistance to penicillin. Between 1998 and 2004, resistance to erythromycin decreased from 42.5 to 35.1%, from 35.1 to 22.8% for cyclins, from 18.8 to 8.8 for chloramphenicol, and from 38.3 to 12.3% for cotrimoxazole. All tested strains were susceptible to both telithromycin and moxifloxacin.. Amoxicillin remains efficient for all strains isolated in the Reunion Island in 2004. The presence of strains with decreased susceptibility to third generation cephalosporins implies combination with vancomycin for empirical treatment of pneumococcal meningitis. Moxifloxacin can be used when using a fluoroquinolone is justified. Telithromycin is efficient even on strains resistant to erythromycin and consequently this molecule can be prescribed in the case of a required macrolide treatment.

Topics: Aza Compounds; beta-Lactams; Cephalosporin Resistance; Cephalosporins; Chloramphenicol; Drug Resistance, Multiple, Bacterial; Fluoroquinolones; Humans; Ketolides; Moxifloxacin; Penicillin Resistance; Quinolines; Retrospective Studies; Reunion; Rifampin; Streptococcal Infections; Streptococcus pneumoniae; Tetracycline; Trimethoprim, Sulfamethoxazole Drug Combination

Group A beta-haemolytic streptococcus (GAS) causes a variety of infections, including life-threatening illnesses. Although the species is uniformly penicillin susceptible, resistance to other antibiotics is becoming more common. We studied the prevalence of resistance and associated factors in a nationwide, prospective, population-based study of invasive infections in Israel. Isolates were collected in collaboration with 24 hospitals in Israel during 1996-1999. Minimal inhibitory concentrations (MICs) of erythromycin (ERY), clindamycin (CLI) and tetracycline (TET) were determined as well as ERY and TET resistance phenotypes and genotypes. Five hundred isolates were examined: 136 (27.2%) were not susceptible to TET, 10 (2.0%) to ERY and 5 (1%) to CLI. ERY resistance was associated with emm types 12 and 83 (P<0.001 for both). MICs of TET had a bimodal distribution distinguishing sensitive and resistant populations. Non-susceptibility to TET was mainly due to the presence of tet(M) and was associated with T types 3, 3/13/B3624 and 9 and emm types 9, 33, 64, 73, 74, 76, 77 and 83. TET susceptibility was associated with T types 1, 2 and 11, emm types 1-4, 11, 12, 22, 26 and 75 and the presence of speA and speC. In Israel, resistance of invasive GAS isolates to ERY remains low and is associated with specific T and emm types, as is TET resistance. TET resistance is less frequent than previously reported in Israel and is associated with a lower prevalence of speA and speC.

Topics: Anti-Bacterial Agents; Bacterial Outer Membrane Proteins; Drug Resistance, Bacterial; Erythromycin; Israel; Lincosamides; Macrolides; Microbial Sensitivity Tests; Streptococcal Infections; Streptococcus pyogenes; Tetracycline

The purpose of this paper is to report a case of corneal staining after treatment with topical tetracycline.. A patient with crystalline keratopathy caused by Streptococcus viridans after corneal transplantation was treated topically with tetracycline eye drops, based on results of bacterial sensitivity testing. After 3 weeks of intensive treatment, the donor cornea was stained with a brownish hue, which was ascribed to the tetracycline drops.. One patient with crystalline keratopathy developed corneal staining after intensive treatment with topical tetracycline eye drops. After a year of follow-up, the staining of the cornea had not changed significantly.. Hourly topical tetracycline eye drops may induce corneal pigmentation. To our knowledge, this is the first published case report of corneal staining caused by tetracycline eye drops.

Topics: Administration, Topical; Aged; Anti-Bacterial Agents; Cornea; Corneal Diseases; Corneal Transplantation; Corneal Ulcer; Eye Infections, Bacterial; Female; Humans; Ophthalmic Solutions; Pigmentation Disorders; Streptococcal Infections; Tetracycline; Viridans Streptococci

In the present report we describe the characteristics of 189 antimicrobial-resistant Streptococcus agalactiae isolates from bovine (38 isolates) and human (151 isolates) sources. All the strains were resistant to tetracycline (TET), and 16 (8.5%) were also resistant to erythromycin, corresponding to 23.7% of the TET-resistant bovine isolates and 4.6% of the TET-resistant human isolates. The tet(O), erm(B), and mreA resistance-related genes, as well as the bca and scpB virulence-related genes, were the most frequent among the bovine isolates, while the tet(M), erm(A), mreA, bca, lmb, and scpB genes were the most prevalent among the isolates from humans. Although a few major clusters were observed, pulsed-field gel electrophoresis results revealed a variety of profiles, reflecting the substantial genetic diversity among strains of this species isolated from either humans or bovines.

Topics: Animals; Bacterial Proteins; Brazil; Cattle; Cattle Diseases; Drug Resistance, Bacterial; Electrophoresis, Gel, Pulsed-Field; Erythromycin; Female; Humans; Mastitis, Bovine; Microbial Sensitivity Tests; Streptococcal Infections; Streptococcus agalactiae; Tetracycline; Virulence

Seven reference strains and seven clinical isolates of Streptococcus iniae, submitted to the Centers for Disease Control and Prevention Streptococcus Reference Laboratory between 2001 and 2004, were successfully identified by a conventional identification system. The seven randomly submitted clinical isolates were sensitive to beta-lactams, macrolides, quinolones, and vancomycin. Two of the seven clinical isolates were resistant to tetracycline. All seven strains grew well and multiplied in a phagocytosis assay. One of the seven randomly submitted strains was more similar to the type strain of S. iniae than to the other six strains. The latter six strains were similar if not identical to representative strains from a cluster of disease in Canada (M. R. Weinstein et al., N. Engl. J. Med. 337:589-594, 1997).

Topics: Animals; Anti-Bacterial Agents; Bacterial Typing Techniques; Dolphins; Drug Resistance, Bacterial; Fish Diseases; Fishes; Humans; Microbial Sensitivity Tests; Phenotype; Streptococcal Infections; Streptococcus; Tetracycline

Between July and October 2003, 121 clinical isolates of group A streptococci (GAS) were collected from a London hospital and characterized by multilocus sequence typing (MLST) to determine the identity and prevalence of clones circulating within this setting. A total of 39 sequence types (ST), of which 20 were represented by a single isolate, were identified. The eight most prevalent clones among the 121 GAS were ST117/emm81 (16%), ST39/emm4 (9%), ST62/emm87 (7%), ST28/emm1 (6%), ST36/emm12 (6%), ST46/emm22 (5%), ST334/emm82 (5%), and ST101/emm89 (4%). Compared to those in the MLST database (http://spyogenes.mlst.net), 12 (31%) of the 39 STs had not been previously identified, although 7 of these differed from recognized STs at only a single locus, suggesting they were closely related to previously recognized strains. Resistance to erythromycin and tetracycline was seen in 7 and 20% of isolates, respectively, with four isolates resistant to both agents. GAS strains with higher (>80) emm types accounted for 45% of GAS isolates collected during this study. Continuing GAS surveillance, using easily comparable methods, is important for detecting changes in the character of disease-causing isolates.

Topics: Anti-Bacterial Agents; Antigens, Bacterial; Bacterial Outer Membrane Proteins; Bacterial Proteins; Bacterial Typing Techniques; Carrier Proteins; Erythromycin; Hospitals, Urban; Humans; London; Microbial Sensitivity Tests; Prevalence; Sequence Analysis, DNA; Streptococcal Infections; Streptococcus pyogenes; Tetracycline

Topics: Anti-Bacterial Agents; Cross Infection; Denmark; Drug Resistance, Bacterial; Genes, Bacterial; Genotype; Humans; Minocycline; Streptococcal Infections; Streptococcus pyogenes; Tetracycline

Streptococcus agalactiae or group B streptococcus, GBS, is the leading cause of neonatal and maternal infections and an opportunistic pathogen in adults with underlying disease. In the last decade, a dramatic increase in the resistance of this microorganism to erythromycin and clindamycin has been observed.. To determine the serotype distribution and antimicrobial susceptibility of isolates of S. agalactiae collected from infections and colonization and to assess the genetic mechanisms of macrolide and clindamycin resistance.. A total of 100 GBS isolates were collected between 1998 and 2002, in Santiago, Chile. They were isolated from the amniotic fluid from patients with premature rupture of membranes (7 isolates), blood from neonatal sepsis (10 isolates), neonate colonizations (2 strains), skin and soft tissue infections (7 isolates), urinary tract infections (5 isolates), genital infections (3 isolates), articular fluid (one isolate), and 65 strains were recovered from vaginal colonization55.. Serotypes Ia, II and III were the predominant serotypes identified in our study, accounting for 90 (90%) of the strains. Five isolates belonged to serotypes Ib (5%) and two (2%) to serotype V respectively; no strains belonging to serotype IV were found. All strains were susceptible to penicillin G, ampicillin and cefotaxime, and four isolates (4%) were resistant to both erythromycin (MIC >64 microg/ml) and clindamycin (MIC >64 microg/ml). The strains had a constitutive macrolide-lincosamide-streptogramin (cMLSB) resistance phenotype and the erm(A) gene was present in the four isolates.. Serotypes Ia, II and III were the predominant serotypes in this study. All strains were susceptible to penicillin G, ampicillin and cefotaxime, and four (4%) strains were resistant to both erythromycin and clindamycin. The cMLSB resistance phenotype, and the erm(A) gene was detected in resistant strains.

Topics: Adult; Ampicillin; Anti-Bacterial Agents; Cefotaxime; Clindamycin; Drug Resistance, Bacterial; Erythromycin; Female; Humans; Infant; Infant, Newborn; Microbial Sensitivity Tests; Phenotype; Pregnancy; Sepsis; Serotyping; Streptococcal Infections; Streptococcus agalactiae; Tetracycline

Dental plaque from 76 children without amalgam restorations was screened for bacteria resistant to mercuric chloride. Seventy-one per cent of the children harboured mercury-resistant oral bacteria and the median percentage of the total oral microflora resistant to mercuric chloride was 0.007% (range 0-5.3%). Eighty-seven mercury-resistant bacteria were isolated and 86% of these were streptococci with Streptococcus mitis predominating. Sixty per cent of the mercury-resistant isolates were also resistant to at least one of the four antibiotics tested (penicillin, ampicillin, erythromycin and tetracycline) with resistance to tetracycline (40% of isolates) most frequently encountered.

Topics: Anti-Bacterial Agents; Child, Preschool; Dental Amalgam; Dental Plaque; Disinfectants; Drug Resistance, Bacterial; Erythromycin; Humans; Mercuric Chloride; Prevalence; Streptococcal Infections; Tetracycline; Tetracyclines; Viridans Streptococci

In the present study 79 streptococcal cultures isolated from subclinical mastitis of 54 cows from seven dairy farms (A-G) in Hesse, Germany, were comparatively investigated using conventional and molecular methods. The isolates could be identified as Streptococcus agalactiae, belonging to Lancefield's serological group B by determination of cultural, biochemical and serological properties and by polymerase chain reaction (PCR)-mediated amplification of species-specific parts of the 16S ribosomal DNA, the 16S-23S rDNA intergenic spacer region and the CAMP factor gene cfb. The investigated group B streptococci were further characterized serologically for specific polysaccharide and protein antigens. Serotyping the isolates revealed a predominance of surface protein antigen X, either alone or in combination with polysaccharide antigen Ia. This could be observed for 39 isolates of farms A, B and C. Six group B streptococci from farm E displayed the serotype pattern III/Rib, two isolates from farm G showed the serotype pattern Ib/calpha. The remaining cultures from farms D and F (n=32) were non-typable. The occurrence of protein Rib could be confirmed by PCR amplification of the gene rib. The two isolates with serotype pattern Ib/calpha also reacted positively for the cbeta-encoding gene bag. Additional properties which allowed a phenotypic characterization of the S. agalactiae were the degree of pigmentation, growth properties in fluid media and soft agar, the surface hydrophobicity, the ability to hemagglutinate rabbit erythrocytes and their resistance reactions to tetracycline and minocycline. The isolates of the seven farms showed identical or almost identical characteristics. The 79 group B streptococci were additionally investigated by macrorestriction analysis of their chromosomal DNA using the restriction endonucleases SmaI, ApaI and SalI. The restriction patterns obtained by pulsed-field gel electrophoresis displayed identical or closely related patterns for the cultures of the various farms. The pheno- and genotypic characteristics of the 79 group B streptococci of the present study revealed that a single S. agalactiae strain or at least closely related subtypes of this strain were responsible for the mastitis situation of the seven farms.

Topics: Animals; Antigens, Bacterial; Bacterial Proteins; Bacterial Typing Techniques; Cattle; Chromosomes, Bacterial; Culture Media; DNA, Bacterial; Electrophoresis, Gel, Pulsed-Field; Germany; Hemagglutination; Mastitis, Bovine; Microbial Sensitivity Tests; Minocycline; Molecular Epidemiology; Polymerase Chain Reaction; Polymorphism, Restriction Fragment Length; Serotyping; Streptococcal Infections; Streptococcus agalactiae; Tetracycline

Mechanisms for tetracycline and macrolide resistance in 54 isolates of erythromycin-resistant Streptococcus agalactiae were analyzed by PCR. The erm(B), erm(A), and mef(A) genes, either alone or in combination, were detected in all the erythromycin-resistant isolates. The tet(M) and tet(O) genes were responsible for tetracycline resistance. Random amplification of polymorphic DNA indicated different clonal origins of the isolates.

Topics: Anti-Bacterial Agents; Bacterial Proteins; Drug Resistance, Bacterial; Erythromycin; Humans; Microbial Sensitivity Tests; Polymerase Chain Reaction; Random Amplified Polymorphic DNA Technique; Streptococcal Infections; Streptococcus agalactiae; Tetracycline; Tetracycline Resistance

Streptococcus pyogenes, a major human pathogen, is still considered susceptible to beta-lactams, but for other relevant antibiotics, highly variable resistance rates have been reported. Since no data were available from Iran, we tested 1,335 throat isolates from two different regions of the country for their antibiotic susceptibilities and, for comparison, a collection of 80 strains isolated from 1989 to 1991. Erythromycin resistance was uncommon (0.6%), whereas an overall high rate of tetracycline resistance was found, increasing between 1989-1991 and 1995-1997 from 23 to 42%. The tetracycline-resistant strains belonged to more than 10 different T types, the majority being types 4, 11, and B3264. By conventional M typing of 406 tetracycline-resistant isolates, more than 20 different M types were found. Approximately 50% of the strains were nontypeable by T agglutination as well as serological M typing; however, by genotyping by a combined PCR-capture-enzyme-linked immunosorbent assay, many of these strains were successfully emm typed. We conclude that the high rate of tetracycline resistance among Iranian S. pyogenes isolates is due to multiclonal dissemination of resistance within the streptococcal population rather than epidemic spread of single clones.

Topics: Antigens, Bacterial; Bacterial Outer Membrane Proteins; Bacterial Proteins; Bacterial Typing Techniques; Carrier Proteins; Child; Electrophoresis, Gel, Pulsed-Field; Erythromycin; Humans; Iran; Streptococcal Infections; Streptococcus pyogenes; Tetracycline; Tetracycline Resistance

Antibiotic susceptibility profiles were analyzed for 119 invasive and 227 colonizing strains of group B streptococci isolated from neonates at 6 US academic centers. All strains were susceptible to penicillin, vancomycin, chloramphenicol, and cefotaxime. The rate of resistance to erythromycin was 20.2% and to clindamycin was 6.9%. Resistance to erythromycin increased in 1997. Type V strains were more resistant to erythromycin than were type Ia (P=.003) and type Ib (P=.004) strains and were more resistant to clindamycin than were type Ia (P<.001), type Ib (P=.01), and type III (P=.001) strains. Resistance rates varied with geographic region: in California, there were high rates of resistance to erythromycin and clindamycin (32% and 12%, respectively), and low rates in Florida (8.5% and 2.1%, respectively). Penicillin continues to be the drug of choice for treatment of group B streptococcus infection. For women who are penicillin intolerant, however, the selection of an alternative antibiotic should be guided by contemporary resistance patterns observed in that region.

Topics: Anti-Bacterial Agents; Bacterial Capsules; Cefotaxime; Chloramphenicol; Clindamycin; Drug Resistance, Microbial; Erythromycin; Female; Humans; Infant, Newborn; Microbial Sensitivity Tests; Ofloxacin; Penicillins; Sepsis; Serotyping; Streptococcal Infections; Streptococcus agalactiae; Tetracycline; Vancomycin

An in vitro model was employed to study the potential role of streptococcal extra-cellular products, rich in streptolysin O, in cellular injury as related to streptococcal infections and post-streptococcal sequelae. Extra-cellular products (EXPA) rich in streptolysin O were isolated from type 4, group A hemolytic streptococci grown in a chemostat, in a synthetic medium. EXPA induced moderate cytopathogenic changes in monkey kidney epithelial cells and in rat heart cells pre-labeled with 3H-arachidonate. However very strong toxic effects were induced when EXP was combined with oxidants (glucose oxides generated H2O2, AAPH-induced peroxyl radical (ROO.), NO generated by sodium nitroprusside) and proteinases (plasmin, trypsin). Cell killing was distinctly synergistic in nature. Cell damage induced by the multi-component cocktails was strongly inhibited either by micromolar amounts of gamma globulin, and Evan's blue which neutralized SLO activity, by tetracycline, trasylol (aprotinin), epsilon amino caproic acid and by soybean trypsin inhibitor, all proteinase inhibitors as well as by a non-penetrating PLA2 inhibitor A. The results suggest that fasciitis, myositis and sepsis resulting from infections with hemolytic streptococci might be caused by a coordinated 'cross-talk' among microbial, leukocyte and additional host-derived pro-inflammatory agents. Since attempts to prolong lives of septic patients by the exclusive administration of single antagonists invariably failed, it is proposed that the administration of 'cocktails' of putative inhibitors against major pro-inflammatory agonizes generated in inflammation and infection might protect against the deleterious effects caused by the biochemical and pharmacological cascades which are known to be activated in sepsis.

Topics: Animals; Anti-Bacterial Agents; Antioxidants; Aprotinin; Arachidonic Acid; Cells, Cultured; Endopeptidases; Epithelial Cells; Erythrocytes; Evans Blue; gamma-Globulins; Haplorhini; Hemolysis; Humans; Hydrogen Peroxide; Myocardium; Oxidants; Phospholipases A; Phospholipases A2; Rats; Shock, Septic; Streptococcal Infections; Streptococcus pyogenes; Streptolysins; Tetracycline

All of the 88 episodes of beta-haemolytic streptococcal bacteremia (2.9% of all bacteremias) in adult patients during the years 1987-94 in a university hospital were reviewed. 38 bacteremias (43%) were caused by group A, 24 (27%) by group B, 3 (4%) by group C, and 23 (26%) by group G beta-haemolytic streptococcal. There was a statistically significant increase in group A and decrease in group C and G bacteremias (p < 0.02) compared to an earlier 8-year period in the same hospital, although the total number of streptococcal bacteremias remained the same. The most common T types of group A streptococcal strains were T11 (26%), T28 (14%), T6 and T1 (11% each), and T12 (8%). Cardiovascular disease, skin lesions, malignancy, and alcohol abuse were the most common underlying conditions. The most usual types of infection were skin (47%) and respiratory tract infections (23%). The overall mortality was 16%. It was highest in group A (24%) and lowest in group C (0%), 38% of patients with pneumonia died. All streptococcal strains were sensitive to penicillin, vancomycin, and cephalosporins. 11% of group A and 12% of all the strains had decreased sensitivity to erythromycin, 14 and 38% to tetracycline, and 0 and 2% to clindamycin, respectively.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Bacteremia; Bacterial Typing Techniques; Cardiovascular Diseases; Clindamycin; Drug Resistance, Microbial; Erythromycin; Female; Finland; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Neoplasms; Retrospective Studies; Skin Diseases; Streptococcal Infections; Streptococcus; Streptococcus agalactiae; Streptococcus pyogenes; Tetracycline

Nasopharyngeal carriage of Streptococcus pneumoniae was studied in 162 healthy infants at ages 2, 4, 6, 7, 12, and 13 months and in an additional 352 healthy children at ages 12, 15, 18, 21, and 24 months. Carriage was 26%, 39%, and 62% at 2, 12, and 24 months, respectively, and the respective resistance to > or = 1 antibiotic was 11%, 19%, and 27%. The presence of an older sibling or antibiotic treatment during the month preceding the culture was associated with carriage of resistant pneumococci in infants, whereas attendance at large day care centers was associated with carriage during the second year of life. Antibiotic resistance was detected in all 7 serotypes included in the candidate pediatric conjugate vaccines and was significantly more prevalent among vaccine-type pneumococci than among non-vaccine-type pneumococci. The use of conjugate vaccines may reduce the spread of resistant pneumococci.

Topics: Anti-Bacterial Agents; Bacterial Vaccines; Bacteriological Techniques; Carrier State; Child Day Care Centers; Child, Preschool; Clindamycin; Drug Resistance, Microbial; Erythromycin; Humans; Infant; Israel; Nasopharynx; Penicillins; Streptococcal Infections; Streptococcus pneumoniae; Tetracycline; Trimethoprim, Sulfamethoxazole Drug Combination; Vaccination

Topics: Acne Vulgaris; Adolescent; Anti-Bacterial Agents; Drug Resistance, Microbial; Erythromycin; Humans; Microbial Sensitivity Tests; Pharyngitis; Streptococcal Infections; Streptococcus pyogenes; Tetracycline

From January 1988 to December 1992, 143 Streptococcus pneumoniae strains have been isolated at a significant level from 136 patients hospitalized in the pulmonary care unit of CHI Créteil. The clinical presentations were: 83 pneumonia (P), 48 acute bronchitis (B) and 12 colonizations (C). Fourteen strains were found to be penicillin resistant (MIC > 0.125 mg. l-1): 11 P, 2 B, 1 C. Two patients were lost of view after the beginning of the treatment: a pneumonia (Serotype 23F, MIC = 2 mg. l-1) and a bronchitis (Serotype 23F, MIC = 2 mg. l-1). Treatment was pristinamycine for one and amoxicilline alone or associated to clavulanic acid for the other 13. We observed the failure of the treatment in two. A pneumonia (Serotype 23, MIC = 2 mg. l-1) was treated before hospitalization by josamycine (3 days), then cefpodoxime (4 days) and amoxicillin-clavulanic acid (1.5 gr/d during 7 days). Healing was obtained with the increase to 3 gr/d. The other failure was a pneumonia without improvement after 11 days with 3 gr/d of amoxicilline. The treatment was stopped during 5 days and a protected brushing was performed. A Streptococcus Pneumoniae (Serotype 23F, MIC = 8 mg. l-1) was isolated. The clinical status rapidly improved with erythromycine (3 gr/d) to which the strain was susceptible. "Bacteriological" Resistance to penicillin is demonstrated (10 percent in our sample, 17 percent in France during 1991). However amoxicillin to a sufficient dosage is still enough ("Clinical" Resistance < 1 percent in our sample) for the treatment of respiratory infections except when the MIC is at a high level.

Topics: Adult; Aged; Aged, 80 and over; Drug Resistance, Microbial; Erythromycin; Female; Humans; In Vitro Techniques; Male; Middle Aged; Penicillin Resistance; Penicillins; Phenols; Pneumonia, Bacterial; Retrospective Studies; Streptococcal Infections; Streptococcus pneumoniae; Tetracycline

A 48-year-old woman, who had undergone reversal of a jejunal loop, presented with skin eruptions, myalgia and arthralgia. Delayed gastric emptying was associated with a gastric phytobezoar. The clinicopathological features and response to therapy were typical of the dermatosis-arthritis syndrome, and probably were related to bacterial overgrowth.

Topics: Anastomosis, Roux-en-Y; Arthritis; Bacterial Infections; Bezoars; Candidiasis; Combined Modality Therapy; Dermatitis; Female; Gastrointestinal Contents; Humans; Intestinal Diseases; Jejunum; Lactobacillus; Middle Aged; Stomach; Streptococcal Infections; Syndrome; Tetracycline

We have investigated the serotypes and sensitivity of 133 pneumococci against 11 antimicrobial agents in the agar dilution test. The strains had been isolated from clinical specimens sent to the Department of Medical Microbiology of the University of Zurich during 1984 and 1985. - Three strains (2.3%) had reduced sensitivity to penicillin G. 23 strains (17.3%) showed resistance or reduced susceptibility to tetracycline, one strain each (0.8%) to amoxycillin and cefaclor, and two strains each (1.5%) to erythromycin and sulfamethoxazole/trimethoprim. All pneumococcal strains investigated were susceptible to ceftazidime, ceftriaxone, chloramphenicol, vancomycin and ciprofloxacin. In view of this situation, routine testing of all clinically significant pneumococci is to be recommended. However, in the agar diffusion test the use of a penicillin G disk is unreliable and may give results with false sensitivity. Therefore, the susceptibility test should be performed with a disk containing oxacillin. - The prevalent capsular serotypes were - in descending order - types 3, 6, 23, 19, 14, 7, 8, 9, 1, and 17. 90.2% of the isolated pneumococci belonged to serotypes which are contained in the new vaccine "Pneumovax-23".

Topics: Amoxicillin; Anti-Bacterial Agents; Cefaclor; Erythromycin; Humans; Microbial Sensitivity Tests; Penicillin G; Penicillin Resistance; Serotyping; Streptococcal Infections; Streptococcus pneumoniae; Sulfamethoxazole; Switzerland; Tetracycline; Trimethoprim

DNA-DNA hybridisation was used to compare the genetic relation of human and bovine strains of Streptococcus agalactiae. All strains showed significant homology under very stringent hybridisation conditions. The extent of relatedness did not correlate with the serological type. It was demonstrated that the S faecalis transposon Tn916 could be inserted randomly into the S agalactiae chromosome when introduced by conjugation. The ability of Tn916 insertion to cause genetic changes in S agalactiae was confirmed by identification of a mutation in lactose and trehalose fermentation associated with acquisition of the transposon. This system should be useful in genetic analysis of the pathogenicity of S agalactiae.

Topics: Animals; Cattle; Conjugation, Genetic; DNA Transposable Elements; DNA, Bacterial; Drug Resistance, Microbial; Female; Humans; Mastitis, Bovine; Nucleic Acid Conformation; Nucleic Acid Hybridization; Streptococcal Infections; Streptococcus agalactiae; Tetracycline

The results of typing all group A streptococci isolated in one laboratory in 5 years were reviewed to see if the collected information showed epidemiological patterns. The great majority of the 5858 streptococci typed came from patients seen in general practice: 72% from throat swabs and 11% from skin lesions. Eight types, M types 1, 2, 3, 4, 6, 12, 22 and type 28 R accounted for 65% of strains. These eight types had different patterns: types 2 and 6 caused small circumscribed outbreaks and were uncommon between epidemics; types 3, 4 and 12 caused larger, wider epidemics, whereas types 1, 22 and 28 R had a more stable pattern. Type 4 was more commonly resistant to tetracycline than most other types, a finding which affected the apparent incidence of tetracycline resistance in group A streptococci. Streptococci from superficial sites were more likely to have serum opacity factor and to lack a detectable M-antigen than strains isolated from the throat. Routine typing of streptococci helped to detect outbreaks of infection in special groups. It is concluded that regular streptococcal typing should be continued in some places.

Topics: Disease Outbreaks; Drug Resistance, Microbial; Humans; Pharynx; Seasons; Serotyping; Skin Diseases, Infectious; Streptococcal Infections; Streptococcus pyogenes; Tetracycline

Streptococcus suis type II was isolated from 170 pigs submitted to a veterinary diagnostic laboratory in Ontario, Canada, over a 1-year period. The most common disease condition with which the organism was identified was suppurative bronchopneumonia, usually secondary to enzootic pneumonia of pigs. The organism was also isolated in cases of pleuropneumonia, valvular endocarditis, arthritis, and vaginitis as well as from aborted fetuses. A condition characterized by neonatal disease and rapid death, usually within the first 24 hours of life, was identified in 23 pigs from 5 farms. Meningitis was identified in 15 weaned pigs from 8 farms. All S suis type II isolates tested for antimicrobial sensitivity were sensitive to penicillin and ampicillin. Most isolates were also sensitive to chloramphenicol and trimethoprim-sulfamethoxazole, but resistant to streptomycin and tetracycline. Accessions from which the organism was isolated were concentrated in the colder months of the year, with few or no isolates recorded in the summer months.

Topics: Animals; Animals, Newborn; Bronchopneumonia; Female; Lung; Penicillins; Seasons; Streptococcal Infections; Streptococcus; Swine; Swine Diseases; Tetracycline

Topics: Bacterial Vaccines; Humans; Penicillins; Rheumatic Fever; Streptococcal Infections; Tetracycline

Two cases of bacterial endocarditis caused by Haemophilus parainfluenzae are reported with a review of 33 other cases of H. parainfluenzae endocarditis and 5 cases of H. influenzae endocarditis. Although H. parainfluenzae is usually considered a non-pathogenic microorganism, this review firmly establishes its role as a causative agent in endocarditis. Furthermore, several clinical features were noted which were atypical when compared to findings usually present in patients with bacterial endocarditis. The mean age of the patients was only 27 years. Over 60% of the patients had no identifiable predisposing illness, an unexpected finding in view of the low degree of pathogenicity associated with this microorganism. Polymicrobial bacteremia, usually with viridans streptococci, was found in 11% of patients. Major arterial emboli were documented in 57% of patients, an incidence unchanged from the pre-antibiotic era. Diagnosis of the disease is dependent upon an awareness of the fastidious cultural requirements necessary for isolation of Haemophilus species. Culture media must contain a source of X and V factors. Mortality from H. parainfluenzae endocarditis has been reduced from 100 per cent prior to 1940 to about 12 per cent by use of appropriate antimicrobial agents. Awareness that Haemophilus species can cause bacterial endocarditis is important because the diagnosis is dependent upon utilization of special culture methods and the patient may not respond to some of the empiric regimens used for treating bacterial endocarditis. It should be especially considered as a possible cause of "culture-negative" or "abacteremic" endocarditis.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Bacteriological Techniques; Cephalothin; Child; Drug Therapy, Combination; Embolism; Endocarditis, Bacterial; Female; Haemophilus; Haemophilus Infections; Haemophilus influenzae; Heart Valve Diseases; Humans; Male; Middle Aged; Streptococcal Infections; Streptomycin; Tetracycline

A sixty-three years old female patient with subacute bacterial endocarditis was treated with clindamycin-2-phosphate parenterally, because she had a history of hypersensitive reaction to penicillins. She had received erythromycin, cephaloridine and cephalexin previously, but had no bacteriological response. When clindamycin-2-phosphate was given intramuscularly, the bacteremia disappeared for the first time. However, after the cessation of this treatment Streptococcus viridans grew in her blood again. It was suggested that this drug was bacteriostatic rather than bactericidal. During this therapy, local tenderness was noticed at the injected sites and a transient maculopapular rash developed which resolved in a few days.

Topics: Clindamycin; Drug Resistance, Microbial; Drug Synergism; Endocarditis, Subacute Bacterial; Female; Humans; Injections, Intramuscular; Middle Aged; Organophosphorus Compounds; Streptococcal Infections; Streptococcus; Tetracycline

Topics: Age Factors; Aged; Anti-Bacterial Agents; Bacteria; Chloramphenicol; Drug Resistance, Microbial; Humans; Kanamycin; Nitrofurantoin; Pneumococcal Infections; Polymyxins; Sepsis; Staphylococcal Infections; Streptococcal Infections; Streptomycin; Sulfamethizole; Tetracycline; United States

Antibiotic therapy has been shown to be of no value in the treatment of the URI--either in shortening the course of the acute illness or in preventing the development of secondary bacterial infections. Patient expense, as well as the threat of adverse reactions, should prohibit the present practice by some of routinely prescribing tetracycline, erythromycin, and ampicillin. Indiscriminate antibiotic therapy cannot substitute for proper diagnostic evaluation of the patient who may have either a bacterial or, far more likely, a viral illness.

Topics: Ampicillin; Anti-Bacterial Agents; Chloramphenicol; Diagnosis, Differential; Diarrhea; Guaiacol; Humans; Mycoplasma Infections; Otitis Media; Penicillin V; Penicillins; Pharyngitis; Prospective Studies; Respiratory Tract Infections; Streptococcal Infections; Sulfonamides; Tetracycline; Vomiting

Tests made with a series of antibiotics against a number of different organisms indicate that if clinical evidence suggests a streptococcal infection, penicillin should be used otherwise erythromycin is preferred.

Topics: Anti-Bacterial Agents; Bacteria; Chloramphenicol; Enterococcus faecalis; Erythromycin; Escherichia coli; Focal Infection, Dental; Humans; Microbial Sensitivity Tests; Penicillins; Staphylococcus; Streptococcal Infections; Streptococcus; Tetracycline; Tooth Diseases

Topics: Animals; Animals, Newborn; Anti-Bacterial Agents; Arthritis, Infectious; Cattle; Cattle Diseases; Cystitis; Diarrhea; Escherichia coli Infections; Female; Foot Diseases; Fusobacterium Infections; Liver Abscess; Mastitis, Bovine; Meningitis; Osteomyelitis; Pasteurella Infections; Pneumonia; Respiratory Tract Infections; Salmonella Infections, Animal; Sheep; Sheep Diseases; Streptococcal Infections; Sulfonamides; Tetracycline; Uterine Diseases

Gonococcal pharyngitis has been correlated with fellatio in both heterosexual females and homosexual males. This report describes another complication of fellatio, group A beta-eaemolytic streptococcal pyroderma on the penis after exposure to a male who probably had pharyngitis. the erythematous, purulent lesions should be cultured. After the organism has been identified, adequate treatment with either a long-acting parenteral penicillin or a 10-day course of oral penicillin is important in order to prevent the possible life-threatening complication of post-streptococcal glomerulonephritis.

Topics: Adult; Homosexuality; Humans; Male; Penile Diseases; Pyoderma; Sexually Transmitted Diseases; Streptococcal Infections; Tetracycline

Topics: Ampicillin; Animals; Anti-Bacterial Agents; Biological Assay; Carbon Radioisotopes; Cattle; Dihydrostreptomycin Sulfate; Erythromycin; Female; Hydrogen-Ion Concentration; Injections; Lactation; Mammary Glands, Animal; Mastitis, Bovine; Milk; Penicillin G; Pregnancy; Streptococcal Infections; Tetracycline; Tritium

Topics: Abortion, Septic; Adolescent; Adult; Anti-Bacterial Agents; Antitoxins; Carbenicillin; Cephalosporins; Complement System Proteins; Endometritis; Escherichia coli Infections; Female; Humans; Methicillin; Muramidase; Penicillin G; Pregnancy; Staphylococcal Infections; Streptococcal Infections; Tetracycline; Tetracyclines

Topics: Adenocarcinoma; Adult; Aged; Ampicillin; Breast Neoplasms; Carcinoma; Cross Infection; Cysts; Disease Outbreaks; Erythromycin; Female; Foot; Gentamicins; Hallux Valgus; Herniorrhaphy; Humans; Kidney Diseases, Cystic; Leg; Male; Middle Aged; Ovarian Diseases; Penicillins; Peptic Ulcer; Quebec; Streptococcal Infections; Surgical Wound Infection; Tetracycline

Topics: Adult; Aged; Ampicillin; Cephalosporins; Child; Chloramphenicol; Drug Therapy, Combination; Endocarditis, Bacterial; Erythromycin; Female; Gastrointestinal Diseases; Gentamicins; Humans; Kanamycin; Lincomycin; Male; Microbial Sensitivity Tests; Middle Aged; Minocycline; Oxacillin; Penicillin G; Streptococcal Infections; Streptococcus; Streptomycin; Tetracycline; Urologic Diseases; Vancomycin

Topics: Abscess; Ampicillin; Calcaneus; Child; Child, Preschool; Chloramphenicol; Cloxacillin; Curettage; Erythromycin; Female; Fusidic Acid; Humans; Male; Osteomyelitis; Penicillins; Radiography; Staphylococcal Infections; Streptococcal Infections; Talus; Tetracycline

Topics: Adolescent; Adult; Child; Child, Preschool; Clindamycin; Erythromycin; Humans; Penicillins; Pharyngitis; Streptococcal Infections; Tetracycline

Bacterial endocarditis was produced by intravenous injection of Streptococcus viridans into rabbits with preexisting sterile endocardial vegetations. After 6 h had elapsed, bacteria in the vegetations could not be eradicated by brief treatment with antimicrobials to which the streptococci were sensitive. However, when treatment with penicillin was continued for 4 days, the animals were cured. The 6-h infection therefore offered a model in which treatments could be conveniently compared over a short period. Synergism was demonstrated between penicillin and streptomycin in endocarditis due to a fully penicillin-sensitive streptococcus, a point which had not been previously proved in vivo. The clinical implications are discussed.

Topics: Animals; Anti-Bacterial Agents; Cephaloridine; Drug Therapy, Combination; Endocarditis, Bacterial; Erythromycin; Penicillin G; Penicillin G Procaine; Penicillin Resistance; Penicillins; Rabbits; Streptococcal Infections; Streptococcus; Streptomycin; Swine; Tetracycline; Vancomycin

Topics: Aminoglycosides; Ampicillin; Anti-Bacterial Agents; Bacteria; Cephalosporins; Chloramphenicol; Clindamycin; Cloxacillin; Drug Hypersensitivity; Erythromycin; Humans; Lincomycin; Penicillin G; Penicillin Resistance; Penicillins; Pneumococcal Infections; Staphylococcal Infections; Streptococcal Infections; Sulfonamides; Tetracycline; Vancomycin

Topics: Adult; Ampicillin; Bacteria; Cephalothin; Child; Chloramphenicol; Culture Media; Cysteine; Endocarditis, Subacute Bacterial; Erythromycin; Female; Humans; Lincomycin; Liver Cirrhosis; Male; Microbial Sensitivity Tests; Middle Aged; Penicillin Resistance; Penicillins; Sepsis; Streptococcal Infections; Streptococcus; Tetracycline; Thioglycolates; Vancomycin

Topics: Ampicillin; Bacitracin; Bacterial Infections; Carbenicillin; Cephalexin; Cephaloridine; Chloramphenicol; Colistin; Dexamethasone; Dicloxacillin; Enterobacteriaceae; Enterobacteriaceae Infections; Gentamicins; Humans; Microbial Sensitivity Tests; Neomycin; Penicillin G; Penicillin Resistance; Root Canal Therapy; Streptococcal Infections; Streptococcus; Tetracycline; Tooth Diseases

Bacteriostatic agents are frequently recommended as alternatives to penicillin for prophylaxis of bacterial endocarditis. To test the efficacy of this group of antimicrobials, prophylaxis of experimental streptococcal endocarditis was attempted with tetracycline. The number of streptococci colonizing the aortic valves of rabbits was not affected by inhibitory levels of tetracycline, but multiplication was checked. Streptococcis urvived in vegetations for seven days despite the continuous presence of tetracycline, and multiplied when the drug was withdrawn. It is therefore suggested that bacteriostatic agents may be valueless for prophylaxis of bacterial endocarditis.

Topics: Animals; Aortic Valve; Bacteriological Techniques; Catheterization; Drug Resistance, Microbial; Endocarditis, Bacterial; Female; Injections, Intramuscular; Male; Rabbits; Streptococcal Infections; Streptococcus; Tetracycline; Time Factors

Topics: Anti-Bacterial Agents; Bacillus; Blood; Cells, Cultured; Culture Media; Endocarditis, Bacterial; Escherichia coli Infections; Humans; Klebsiella Infections; Microbial Sensitivity Tests; Penicillin Resistance; Penicillins; Pseudomonas Infections; Salmonella Infections; Sepsis; Staphylococcal Infections; Streptococcal Infections; Tetracycline

Topics: Anti-Bacterial Agents; Chloramphenicol; Drug Therapy, Combination; Erythromycin; Escherichia coli; Escherichia coli Infections; Nitrofurantoin; Oleandomycin; Penicillin Resistance; Penicillins; Proteus; Proteus Infections; Pseudomonas; Pseudomonas Infections; Pyelonephritis; Staphylococcal Infections; Staphylococcus; Streptococcal Infections; Streptococcus; Tetracycline

Topics: Adult; Bacteroides Infections; Drug Resistance, Microbial; Female; Humans; Hyperbaric Oxygenation; Kanamycin; Methods; Oxygen; Oxygen Inhalation Therapy; Partial Pressure; Pregnancy; Sepsis; Streptococcal Infections; Tetracycline

Topics: Actinomycetales Infections; Anaerobiosis; Anti-Bacterial Agents; Bacterial Infections; Bacteroides Infections; Cephalosporins; Chloramphenicol; Clindamycin; Clostridium Infections; Erythromycin; Fusobacterium; Humans; Lincomycin; Metronidazole; Microbial Sensitivity Tests; Oxygen; Penicillins; Rifampin; Streptococcal Infections; Tetracycline; Treponemal Infections; Vancomycin; Veillonella

Topics: Acute Disease; Age Factors; Ampicillin; Anti-Bacterial Agents; Child, Preschool; Chloramphenicol; Colistin; Erythromycin; Haemophilus; Haemophilus Infections; Humans; Infant; Infant, Newborn; Microbial Sensitivity Tests; Otitis Media; Penicillins; Pneumococcal Infections; Staphylococcal Infections; Staphylococcus; Streptococcal Infections; Streptococcus pneumoniae; Streptococcus pyogenes; Streptomycin; Tetracycline

Topics: Disease Outbreaks; Erythromycin; Humans; Male; Naval Medicine; Penicillin G Benzathine; Penicillin V; Pharyngitis; Ships; Streptococcal Infections; Streptococcus; Tetracycline

Topics: Adolescent; Child; Child, Preschool; Female; Furunculosis; Humans; Infant; Male; Microbial Sensitivity Tests; Minocycline; Otitis Media; Otorhinolaryngologic Diseases; Pneumococcal Infections; Staphylococcal Infections; Streptococcal Infections; Tetracycline; Tonsillitis

The prevalence of tetracycline-resistant beta-haemolytic streptococci in South-west Essex has been recorded over the past 10 years. It has fallen from a peak of 35% in 1965 to a level of 9.2% in 1972. Ear infections no longer provide the highest incidence of these organisms; vaginal, perineal, and skin infections now seem to be of greater relative importance but throat swabs still provide the greatest actual number of isolations. Erythromycin-resistant strains are still rare.

Topics: Drug Resistance, Microbial; Ear; Ear Diseases; England; Erythromycin; Female; Humans; Nose; Paranasal Sinuses; Perineum; Pharynx; Skin Diseases; Sputum; Streptococcal Infections; Streptococcus pyogenes; Tetracycline; Vaginal Diseases; Vulva; Wounds and Injuries

Topics: Administration, Oral; Adult; Aged; Bacterial Infections; Doxycycline; Enterobacteriaceae Infections; Escherichia coli Infections; Female; Humans; In Vitro Techniques; Klebsiella Infections; Male; Methacycline; Microbial Sensitivity Tests; Middle Aged; Oxytetracycline; Respiratory Tract Infections; Staphylococcal Infections; Streptococcal Infections; Tetracycline; Urinary Tract Infections

The effectiveness of various antibiotics commonly recommended for the prophylaxis of bacterial endocarditis has been evaluated in experimental streptococcal endocarditis in rabbits. High doses of penicillin G did not prevent the development of this infection. The only consistently successful prophylactic regimens using penicillin alone were those which provided for both an early high serum level and more than 9 h of effective antimicrobial action. Vancomycin was the only other drug which proved uniformly successful when given alone, even though the duration of its antimicrobial action in the blood was only 3 h. However, combined therapy using penicillin G or ampicillin with streptomycin was always effective in prophylaxis. Treatment with single injections of ampicillin, cephaloridine, cephalexin, clindamycin, cotrimoxazole, rifampicin, streptomycin, erythromycin, and tetracycline failed to prevent infection. The findings provide information on the effect of antimicrobials in vivo and may be applicable to the chemoprophylaxis of infective endocarditis in clinical practice.

Topics: Ampicillin; Animals; Cephaloridine; Clindamycin; Endocarditis, Bacterial; Erythromycin; Female; Male; Penicillin G; Rabbits; Rifampin; Streptococcal Infections; Streptomycin; Tetracycline; Vancomycin

Topics: Ampicillin; Anti-Bacterial Agents; Blood Bactericidal Activity; Cephalothin; Clindamycin; Endocarditis, Bacterial; Endocarditis, Subacute Bacterial; Erythromycin; Gentamicins; Humans; New York City; Oxacillin; Penicillins; Sepsis; Streptococcal Infections; Streptococcus; Streptomycin; Tetracycline; Vancomycin

Topics: Blind Loop Syndrome; Constipation; Diarrhea; Diverticulum; Duodenal Diseases; Ehlers-Danlos Syndrome; Humans; Ileum; Male; Middle Aged; Mitral Valve Insufficiency; Peptic Ulcer; Streptococcal Infections; Tetracycline

Topics: Acidosis; Clostridium Infections; Clostridium perfringens; Endocarditis, Bacterial; Enterococcus faecalis; Heart Failure; Humans; Male; Middle Aged; Penicillin Resistance; Penicillins; Streptococcal Infections; Streptomycin; Tetracycline

Topics: Administration, Oral; Evaluation Studies as Topic; Half-Life; Kinetics; Medication Systems, Hospital; Penicillin Resistance; Penicillins; Protein Binding; Referral and Consultation; Staphylococcal Infections; Streptococcal Infections; Tetracycline; Time Factors

Topics: Cross Infection; Streptococcal Infections; Tetracycline

Topics: Drug Resistance, Microbial; Hemolysin Proteins; Humans; Microbial Sensitivity Tests; Serotyping; Skin Diseases; Streptococcal Infections; Streptococcus; Tetracycline

Topics: Animals; Anti-Bacterial Agents; Bites and Stings; Cats; Child; Dogs; Facial Injuries; Hand Injuries; Humans; Male; Pasteurella; Pasteurella Infections; Penicillin G; Rats; Staphylococcal Infections; Staphylococcus; Streptococcal Infections; Streptococcus; Tetracycline; Wound Infection

Topics: Drug Resistance, Microbial; Ear Diseases; Humans; Microbial Sensitivity Tests; Nose Diseases; Pharyngeal Diseases; Streptococcal Infections; Streptococcus; Tetracycline

Topics: Drug Resistance, Microbial; Humans; Streptococcal Infections; Streptococcus; Tetracycline

Topics: Animals; Bacteria; Blood Proteins; Drug Resistance, Microbial; Escherichia coli; Hydrogen-Ion Concentration; Klebsiella; Klebsiella Infections; Mice; Microbial Sensitivity Tests; Ovalbumin; Pneumococcal Infections; Proline; Staphylococcal Infections; Staphylococcus; Streptococcal Infections; Tetracycline; Tetracyclines

Topics: Acute Disease; Child; Cholesteatoma; Cholesterol; Chronic Disease; Drug Resistance, Microbial; Ear, Middle; Granuloma; Haemophilus Infections; Hearing Disorders; Humans; Mastoiditis; Mucous Membrane; Ossification, Heterotopic; Otitis Media; Streptococcal Infections; Tetracycline

Topics: Administration, Oral; Animals; Drug Synergism; Edetic Acid; Escherichia coli Infections; Injections, Subcutaneous; Mice; Penicillin G; Salmonella Infections, Animal; Streptococcal Infections; Tetracycline

Topics: Animals; Cyanoacrylates; Female; Klebsiella Infections; Male; Rats; Staphylococcal Infections; Streptococcal Infections; Tetracycline; Tissue Adhesives; Vancomycin; Wound Infection

Topics: Aged; Cephalosporins; Chloramphenicol; Digitalis Glycosides; Erythromycin; Female; Humans; Infections; Oxygen Inhalation Therapy; Penicillins; Pneumococcal Infections; Pneumonia; Respiratory Insufficiency; Streptococcal Infections; Tetracycline

Topics: Adult; Biopsy; Chronic Disease; Humans; L Forms; Male; Necrosis; Pharyngitis; Stomatitis, Aphthous; Streptococcal Infections; Tetracycline; Triamcinolone Acetonide

Topics: Adolescent; Adult; Aged; Candidiasis; Chloramphenicol; Female; Haemophilus Infections; Humans; Leukorrhea; Male; Middle Aged; Penicillins; Pregnancy; Staphylococcal Infections; Streptococcal Infections; Tetracycline; Trichomonas Infections; Vaginal Smears; Vaginitis; Vibrio Infections

Topics: Ampicillin; Anti-Bacterial Agents; Drug Synergism; Endocarditis, Bacterial; Humans; Penicillin G; Penicillins; Sepsis; Streptococcal Infections; Streptomycin; Tetracycline; Vancomycin

Topics: Adult; Aged; Ampicillin; Anti-Bacterial Agents; Chloramphenicol; Chronic Disease; Colistin; Depression, Chemical; Drug Synergism; Erythromycin; Escherichia coli Infections; Female; Follow-Up Studies; Humans; Kanamycin; Klebsiella Infections; Male; Middle Aged; Nitrofurantoin; Oleandomycin; Oxacillin; Penicillins; Polymyxins; Proteus Infections; Pyelonephritis; Staphylococcal Infections; Stimulation, Chemical; Streptococcal Infections; Streptomycin; Sulfonamides; Tetracycline

Topics: Adult; Cephalothin; Chronic Disease; Humans; Male; Parotid Gland; Parotitis; Pneumococcal Infections; Streptococcal Infections; Streptococcus pneumoniae; Tetracycline

Topics: Adult; Agglutination Tests; Carrier State; Humans; Hungary; Penicillin Resistance; Penicillins; Precipitin Tests; Rural Population; Scarlet Fever; Serotyping; Streptococcal Infections; Streptococcus pyogenes; Tetracycline; Tonsillitis; Urban Population

Topics: Female; Humans; Penicillin Resistance; Penicillins; Pregnancy; Puerperal Infection; Sepsis; Streptococcal Infections; Tetracycline

Topics: Acute Disease; Age Factors; Anti-Bacterial Agents; Child; Child, Preschool; Female; Femur; Haemophilus Infections; Humans; Humerus; Infant; Infant, Newborn; Male; Osteomyelitis; Penicillin Resistance; Penicillins; Proteus Infections; Radiography; Radius; Salmonella Infections; Seasons; Sepsis; Splints; Staphylococcal Infections; Streptococcal Infections; Tetracycline; Tibia; Ulna

Topics: Age Factors; Ampicillin; Anti-Bacterial Agents; Arthritis, Infectious; Bacterial Infections; Erythromycin; Female; Hand Injuries; Humans; Infections; Lincomycin; Male; Penicillin Resistance; Penicillins; Sex Factors; Staphylococcal Infections; Staphylococcus; Streptococcal Infections; Streptococcus; Tetracycline

Topics: Air Microbiology; Carrier State; Chloramphenicol; Cross Infection; Dust; Germany, East; Hand; Humans; Nose; Penicillin Resistance; Penicillins; Pharynx; Staphylococcal Infections; Staphylococcus; Sterilization; Streptococcal Infections; Streptococcus; Streptomycin; Surgical Wound Infection; Tetracycline

Topics: Bronchial Diseases; Chloramphenicol; Humans; Lung Diseases; Microbial Sensitivity Tests; Pseudomonas Infections; Rifampin; Staphylococcal Infections; Streptococcal Infections; Tetracycline

Topics: Acute Disease; Anti-Infective Agents; Chronic Disease; Hearing Disorders; Humans; Otitis Media; Penicillins; Pneumococcal Infections; Staphylococcal Infections; Streptococcal Infections; Sulfonamides; Tetracycline

Topics: Adolescent; Adult; Hair; Humans; Male; Skin Diseases, Infectious; Soaps; Staphylococcal Infections; Streptococcal Infections; Tetracycline

Topics: Abscess; Ampicillin; Anti-Bacterial Agents; Bacteriological Techniques; Cellulitis; Cephalothin; Chloramphenicol; Colistin; Erythromycin; Escherichia coli; Escherichia coli Infections; Hand; Humans; Infections; Kanamycin; Lincomycin; Methicillin; Penicillin Resistance; Penicillins; Polymyxins; Staphylococcal Infections; Staphylococcus; Streptococcal Infections; Streptococcus; Streptomycin; Tetracycline; Wound Infection

Topics: Biopsy; Diagnosis, Differential; Diverticulum; Humans; Intestinal Obstruction; Jejunum; Malabsorption Syndromes; Male; Middle Aged; Staphylococcal Infections; Streptococcal Infections; Tetracycline

Topics: Communicable Disease Control; Cross Infection; Disease Outbreaks; Drug Resistance, Microbial; Female; Hospitals, Special; Humans; London; Male; Neomycin; Pseudomonas aeruginosa; Skin Diseases; Streptococcal Infections; Streptococcus; Tetracycline

Topics: Anti-Bacterial Agents; Bacillus subtilis; Cephalosporins; Cornea; Escherichia coli Infections; Eye Diseases; Humans; Infections; Neisseria; Penicillins; Pneumococcal Infections; Proteus Infections; Staphylococcal Infections; Streptococcal Infections; Tetracycline

Topics: Acute Disease; Animals; Chronic Disease; Kidney; Proteus Infections; Pyelonephritis; Rats; Streptococcal Infections; Tetracycline; Tritium

Topics: Ampicillin; Anti-Bacterial Agents; Cephalosporins; Child; Cloxacillin; Colistin; Drug Synergism; Dysentery, Bacillary; Endocarditis, Bacterial; Humans; Infections; Lincomycin; Meningitis; Nafcillin; Neomycin; Oxacillin; Penicillin Resistance; Penicillins; Pneumococcal Infections; Polymyxins; Shigella; Streptococcal Infections; Sulfamethoxazole; Tetracycline; Urinary Tract Infections

Topics: Adrenocorticotropic Hormone; Cardiomegaly; Convalescence; Digitalis Glycosides; Diuretics; Endocarditis, Bacterial; Erythromycin; Glucocorticoids; Heart Failure; Humans; Injections, Intramuscular; Penicillins; Pericarditis; Rheumatic Heart Disease; Socioeconomic Factors; Streptococcal Infections; Tetracycline

Topics: Erythromycin; Female; Humans; Infant; Lincomycin; Penicillin Resistance; Penicillin V; Respiratory Tract Infections; Streptococcal Infections; Streptococcus pyogenes; Tetracycline

Topics: Adult; Anal Canal; Carrier State; Cephalothin; Female; Humans; Injections, Intramuscular; Penicillin G; Penicillin Resistance; Penicillin V; Postoperative Complications; Pregnancy; Puerperal Infection; Streptococcal Infections; Streptococcus pyogenes; Tetracycline; Vancomycin

Studies of beta-haemolytic streptococci isolated in material received from patients in South-west Essex for a further period of three years showed that the overall percentage of tetracycline resistance has remained almost stationary, varying from 28% in 1963 through 35% in 1965 to 27% in 1967.Ear, sound, and skin infections retain a high incidence of resistant strains, while sputa are still a relatively minor source of such organisms. Organisms isolated from throat swabs have an incidence of resistance closest to the mean.

Topics: Chloramphenicol; England; Erythromycin; Humans; Penicillin Resistance; Penicillins; Precipitin Tests; Sputum; Streptococcal Infections; Streptococcus; Tetracycline; Wound Infection

Topics: Humans; Otorhinolaryngologic Diseases; Penicillin G; Penicillin Resistance; Streptococcal Infections; Tetracycline

Topics: Adult; Anti-Bacterial Agents; Chloramphenicol; Diabetic Neuropathies; Exudates and Transudates; Female; Humans; Male; Meningitis; Myocarditis; Penicillins; Pregnancy; Puerperal Infection; Streptococcal Infections; Streptococcus; Streptomycin; Tetracycline; Vaginal Smears

Topics: Drug Resistance, Microbial; Female; Humans; Male; Streptococcal Infections; Surgical Wound Infection; Tetracycline

Topics: Adolescent; Adult; Aged; Child; Drug Resistance, Microbial; Female; Humans; Infant; Male; Middle Aged; Streptococcal Infections; Surgical Wound Infection; Tetracycline

Topics: Bacteria; Cephalosporins; Chloramphenicol; Drug Antagonism; Drug Incompatibility; Humans; Infections; Nitrofurantoin; Penicillin G; Penicillin Resistance; Penicillins; Polymyxins; Proteus Infections; Pseudomonas Infections; Staphylococcal Infections; Streptococcal Infections; Sulfonamides; Surgical Wound Infection; Tetracycline

Topics: Adrenal Cortex Hormones; Anaphylaxis; Drug Hypersensitivity; Endocarditis, Bacterial; Erythromycin; Histamine H1 Antagonists; Humans; Penicillins; Skin Tests; Streptococcal Infections; Streptomycin; Tetracycline; Vancomycin

Topics: Humans; Penicillin Resistance; Penicillins; Pneumococcal Infections; Streptococcal Infections; Streptococcus; Streptococcus pneumoniae; Tetracycline

Topics: Adult; Candidiasis; Escherichia coli Infections; Female; Haemophilus Infections; Humans; Lactobacillus; Mycoplasma Infections; Streptococcal Infections; Tetracycline; Trichomonas Vaginitis; Vaginitis

Topics: Adult; Ascorbic Acid; Chronic Disease; Escherichia coli Infections; Female; Humans; Infections; Lung Diseases; Male; Middle Aged; Osteomyelitis; Peritonitis; Pleural Diseases; Pneumonia; Staphylococcal Infections; Streptococcal Infections; Suppuration; Surgical Wound Infection; Tetracycline; Thiamine

Topics: Penicillin Resistance; Penicillins; Pharyngitis; Rheumatic Fever; Romania; Scarlet Fever; Streptococcal Infections; Streptococcus pyogenes; Tetracycline

Topics: Adult; Child; Humans; Isoniazid; Meningitis; Meningococcal Infections; Penicillins; Pneumococcal Infections; Staphylococcal Infections; Streptococcal Infections; Streptomycin; Sulfisoxazole; Suppuration; Tetracycline; Tuberculosis, Meningeal

The incidence of tetracycline-resistant beta-haemolytic streptococci isolated in the Department of Pathology and Bacteriology of the Institute of Laryngology and Otology, London, during the years 1958-65 is reported. From less than 1% of all beta-haemolytic streptococci isolated in 1958 they increased to 44% in 1965. These findings are discussed.

Topics: Drug Resistance, Microbial; Humans; Otorhinolaryngologic Diseases; Streptococcal Infections; Streptococcus; Surgical Wound Infection; Tetracycline

Topics: Animals; Humans; In Vitro Techniques; Mice; Staphylococcal Infections; Streptococcal Infections; Surgery, Oral; Tetracycline; Tooth Diseases

Topics: Agglutination Tests; Hungary; International Cooperation; Penicillin Resistance; Penicillins; Precipitin Tests; Streptococcal Infections; Streptococcus pyogenes; Tetracycline

Topics: Carrier State; Child; Chloramphenicol; Drug Synergism; Erythromycin; Female; Humans; Male; Meningitis; Penicillins; Sepsis; Streptococcal Infections; Tetracycline; Tonsillitis

Topics: Cholangitis; Erysipelas; Female; Humans; Male; Measles; Pharyngitis; Respiratory Tract Infections; Smallpox; Streptococcal Infections; Tetracycline

Topics: Animals; Anti-Bacterial Agents; Bacitracin; Chemotherapy, Cancer, Regional Perfusion; Chloramphenicol; Clostridium perfringens; Dogs; Drug Therapy; Erythromycin; Gas Gangrene; Hyperbaric Oxygenation; Leg; Novobiocin; Research; Streptococcal Infections; Tetracycline

Topics: Drug Resistance; Drug Resistance, Microbial; Drug Therapy; Humans; Otitis Media; Respiratory Tract Infections; Streptococcal Infections; Streptococcus; Tetracycline

Topics: Bacteriological Techniques; Drug Resistance; Drug Resistance, Microbial; Drug Therapy; England; Humans; Laryngitis; Otitis Media; Respiratory Tract Infections; Sinusitis; Streptococcal Infections; Tetracycline

Topics: Adult; Anti-Bacterial Agents; Arthritis, Infectious; Drainage; Drug Therapy; Escherichia coli Infections; Hip Joint; Humans; Pseudomonas Infections; Radiography; Staphylococcal Infections; Streptococcal Infections; Surgical Procedures, Operative; Tetracycline

Topics: Bacteriological Techniques; Cross Infection; England; Humans; Penicillin Resistance; Penicillins; Streptococcal Infections; Streptococcus; Tetracycline

Topics: Cross Infection; Drug Resistance, Microbial; Humans; Streptococcal Infections; Streptococcus; Tetracycline

Topics: Carrier State; Child; Demeclocycline; Dosage Forms; Drug Resistance; Drug Resistance, Microbial; Humans; Penicillin G; Penicillin V; Pharyngitis; Pharynx; Phosphates; Potassium; Respiratory Tract Infections; Streptococcal Infections; Tetracycline; Tonsillitis

Topics: Anti-Bacterial Agents; Erythromycin; Humans; Penicillins; Pharyngitis; Streptococcal Infections; Sulfadiazine; Sulfamethoxazole; Sulfanilamide; Sulfanilamides; Sulfisoxazole; Sulfonamides; Tetracycline

Topics: Amphotericin B; Anti-Bacterial Agents; Antibiotic Prophylaxis; Enterobacter aerogenes; Escherichia coli Infections; Humans; Infant, Newborn; Proteus Infections; Pseudomonas Infections; Spinal Dysraphism; Staphylococcal Infections; Streptococcal Infections; Tetracycline

Topics: Adolescent; Anti-Bacterial Agents; Bacillus; Child; Drug Resistance, Microbial; Humans; Oleandomycin; Otolaryngology; Penicillin Resistance; Penicillins; Staphylococcal Infections; Streptococcal Infections; Streptomycin; Tetracycline; Toxicology; Troleandomycin

Topics: Anti-Bacterial Agents; Bacitracin; Child; Chloramphenicol; Chlortetracycline; Drainage; Empyema; Erythromycin; Escherichia coli Infections; Haemophilus influenzae; Humans; Infant; Infant, Newborn; Kanamycin; Novobiocin; Oleandomycin; Pediatrics; Penicillins; Pneumococcal Infections; Pneumothorax; Staphylococcal Infections; Streptococcal Infections; Sulfonamides; Surgical Procedures, Operative; Tetracycline; Vancomycin

Clinical and pathological features of two fatal cases of bacterial endocarditis with Candida albicans superinfection are described. One patient presented with combined Streptococcus viridans and Candida endocarditis of the aortic valve. The second patient, an addict to paregoric injected intravenously, developed Staphylococcus aureus of the tricuspid valve with eventual Candida endocarditis. The responsible organisms were identified from blood cultures during the hospital course, and by culture or tissue section of postmortem material. Candida endocarditis has emerged as a disease entity in the past 20 years. The incidence is increasing and patients with bacterial endocarditis are among those at risk. Antibiotic therapy appeared to facilitate the development of Candida endocarditis in these two cases.

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Aortic Valve; Candida albicans; Candidiasis; Dermatologic Agents; Endocarditis; Endocarditis, Bacterial; Heart Valve Diseases; Humans; Middle Aged; Pathology; Penicillins; Staphylococcal Infections; Staphylococcus aureus; Streptococcal Infections; Superinfection; Tetracycline; Tricuspid Valve; Viridans Streptococci

Topics: Anti-Bacterial Agents; Bacteria; Biopsy; Candidiasis; Chloramphenicol; Clostridium; Corynebacterium; Electrons; Fusobacterium; Haemophilus; Humans; Jejunum; Lactobacillus; Leptospirosis; Lipodystrophy; Micrococcus; Microscopy; Microscopy, Electron; Neisseria; Penicillins; Staphylococcal Infections; Streptococcal Infections; Streptomyces; Sulfonamides; Tetracycline; Tooth Extraction; Veillonella; Whipple Disease

Topics: Amphotericin B; Anti-Bacterial Agents; Bacitracin; Chloramphenicol; Cross Infection; Drug Hypersensitivity; Drug Resistance; Drug Resistance, Microbial; Erythromycin; Kanamycin; Methicillin; Mycoses; Penicillins; Staphylococcal Infections; Streptococcal Infections; Tetracycline; Toxicology; Vancomycin

Topics: Abortion, Septic; Anti-Bacterial Agents; Bile Ducts; Chloramphenicol; Emetine; Escherichia coli Infections; Female; Humans; Kanamycin; Neomycin; Oxytetracycline; Paraplegia; Penicillins; Peritonitis; Pregnancy; Pressure Ulcer; Pseudomonas Infections; Pyelonephritis; Pyoderma; Staphylococcal Infections; Streptococcal Infections; Streptomycin; Tetracycline

Topics: Achromobacter; Anti-Bacterial Agents; Bacteriology; Chloramphenicol; Drug Resistance; Drug Resistance, Microbial; Erythromycin; Escherichia coli Infections; Haemophilus influenzae; Klebsiella; Maxillary Sinus; Maxillary Sinusitis; Penicillin V; Penicillins; Placebos; Pneumococcal Infections; Proteus Infections; Sinusitis; Staphylococcal Infections; Streptococcal Infections; Tetracycline

Topics: Adolescent; Anti-Bacterial Agents; Antibiotic Prophylaxis; Burns; Child; Chloramphenicol; Colistin; Erythromycin; Escherichia coli Infections; gamma-Globulins; Humans; Immune Sera; Infant; Infant, Newborn; Kanamycin; Novobiocin; Polymyxins; Proteus Infections; Pseudomonas Infections; Salmonella Infections; Sepsis; Serum Albumin; Shigella; Sodium Chloride; Solutions; Staphylococcal Infections; Streptococcal Infections; Tetracycline; Vancomycin

Topics: Aeromonas; Alcoholism; Ascites; Bacteremia; Escherichia coli Infections; Geriatrics; Humans; Intestines; Liver Cirrhosis; Liver Function Tests; Neomycin; Novobiocin; Penicillins; Peritonitis; Sepsis; Streptococcal Infections; Streptomycin; Tetracycline

Topics: Amphotericin B; Anti-Bacterial Agents; Chloramphenicol; Colistin; Drug Resistance; Drug Resistance, Microbial; Endocarditis; Endocarditis, Bacterial; Enterobacter aerogenes; Enterobacteriaceae; Erythromycin; Escherichia coli Infections; Kanamycin; Penicillin G; Penicillins; Proteus Infections; Pseudomonas Infections; Ristocetin; Staphylococcal Infections; Streptococcal Infections; Streptomycin; Tetracycline; Vancomycin

Topics: Anti-Bacterial Agents; Chloramphenicol; Erythromycin; Escherichia coli Infections; Haemophilus; Humans; Meningitis; Meningitis, Haemophilus; Meningitis, Meningococcal; Meningitis, Pneumococcal; Penicillins; Proteus Infections; Streptococcal Infections; Streptomycin; Sulfonamides; Tetracycline

Topics: Anti-Bacterial Agents; Chloramphenicol; Drug Resistance; Drug Resistance, Microbial; Erythromycin; Humans; Penicillins; Pharmacology; Pneumococcal Infections; Staphylococcal Infections; Streptococcal Infections; Tetracycline; Troleandomycin

Topics: Bacteremia; Bacteriological Techniques; Chloramphenicol; Drug Therapy; Erythromycin; Immunization, Passive; Klebsiella; Leukocyte Count; New York; Penicillins; Pneumococcal Infections; Pneumonia; Pneumonia, Pneumococcal; Sepsis; Statistics as Topic; Streptococcal Infections; Streptomycin; Tetracycline

Topics: Anti-Bacterial Agents; Australia; Bacteriological Techniques; Drug Resistance; Drug Resistance, Microbial; Humans; Statistics as Topic; Streptococcal Infections; Streptococcus; Streptococcus pyogenes; Tetracycline

Topics: Anti-Bacterial Agents; Boston; Chloramphenicol; Cross Infection; Drug Therapy; Erythromycin; Escherichia coli Infections; Hospitals, Urban; Humans; Kanamycin; Klebsiella; Massachusetts; Penicillins; Pneumococcal Infections; Proteus Infections; Staphylococcal Infections; Statistics as Topic; Streptococcal Infections; Sulfonamides; Tetracycline

Topics: Anti-Bacterial Agents; Child; Chloramphenicol; Drug Resistance, Microbial; Epidemiology; Erythromycin; Humans; Japan; Penicillin Resistance; Prevalence; Scarlet Fever; Statistics as Topic; Streptococcal Infections; Streptococcus pyogenes; Tetracycline

Topics: Bacteroides; Cardiac Surgical Procedures; Chloramphenicol; Drug Therapy; Endocarditis; Endocarditis, Bacterial; Erythromycin; Escherichia coli Infections; Klebsiella; Norway; Penicillins; Sepsis; Staphylococcal Infections; Streptococcal Infections; Streptomycin; Sulfonamides; Surgical Wound Infection; Tetracycline; Thoracic Surgery

Topics: Anti-Bacterial Agents; Bacteria; Mice; Pharmacology; Research; Staphylococcal Infections; Streptococcal Infections; Tetracycline

Topics: Animals; Anti-Bacterial Agents; Cattle; Chloramphenicol; Female; Food Contamination; Humans; Mastitis; Mastitis, Bovine; Milk; Penicillins; Preventive Medicine; Staphylococcal Infections; Streptococcal Infections; Streptomycin; Tetracycline; Toxicology

Topics: Adolescent; Chloramphenicol; Frontal Bone; Frontal Sinus; Humans; Methicillin; Osteomyelitis; Plastics; Radiography; Sinusitis; Skull; Staphylococcal Infections; Streptococcal Infections; Streptomycin; Sulfonamides; Surgery, Plastic; Surgical Procedures, Operative; Tetracycline

Topics: Anti-Bacterial Agents; Humans; Penicillins; Sepsis; Streptococcal Infections; Streptococcus equi; Tetracycline

Topics: Abscess; Arthritis; Child; Chloramphenicol; Diagnosis, Differential; Drainage; Erythromycin; Humans; Infant; Joint Diseases; Novobiocin; Osteomyelitis; Oxytetracycline; Penicillins; Sepsis; Staphylococcal Infections; Streptococcal Infections; Suppuration; Surgical Procedures, Operative; Tetracycline

Topics: Amphotericin B; Anti-Bacterial Agents; Candidiasis; Chloramphenicol; Endocarditis; Endocarditis, Bacterial; Humans; Kanamycin; Penicillins; Staphylococcal Infections; Streptococcal Infections; Streptomycin; Tetracycline; Vancomycin

Topics: Adolescent; Amphotericin B; Child; Diphtheria; Enterovirus Infections; Escherichia coli Infections; Humans; Infant; Otolaryngology; Phosphates; Pneumococcal Infections; Pseudomonas Infections; Staphylococcal Infections; Streptococcal Infections; Tetracycline

Topics: Adrenal Cortex Hormones; Anti-Bacterial Agents; Blood Transfusion; Child; Chlortetracycline; Humans; IgA Vasculitis; Infant; Infusions, Parenteral; Muscle Relaxants, Central; Penicillins; Purpura; Statistics as Topic; Streptococcal Infections; Sulfisoxazole; Tetracycline

Topics: Chemoprevention; Child; Communicable Disease Control; Humans; Malaria; Penicillins; Preventive Medicine; Rheumatic Fever; Sexually Transmitted Diseases; Streptococcal Infections; Tetracycline; Tuberculosis; Whooping Cough

Topics: Adolescent; Anti-Bacterial Agents; Brain Abscess; Child; Chloramphenicol; Geriatrics; Meningitis; Meningitis, Meningococcal; Meningitis, Pneumococcal; Penicillins; Staphylococcal Infections; Streptococcal Infections; Streptomycin; Tetracycline

Topics: Anti-Bacterial Agents; Bacterial Infections; Drug Resistance; Drug Resistance, Microbial; Endocarditis; Endocarditis, Bacterial; Humans; Oleandomycin; Staphylococcal Infections; Streptococcal Infections; Tetracycline

Topics: Adolescent; Bacteriological Techniques; Humans; Sinusitis; Streptococcal Infections; Streptococcus; Tetracycline

Topics: Anti-Bacterial Agents; Arthritis; Arthritis, Rheumatoid; Erythromycin; Geriatrics; Hydrocortisone; Middle Aged; Novobiocin; Penicillins; Sepsis; Staphylococcal Infections; Streptococcal Infections; Streptomycin; Suppuration; Tetracycline

Topics: Animals; Anti-Bacterial Agents; Bacteremia; Mice; Protein Synthesis Inhibitors; Streptococcal Infections; Tetracycline

Topics: Anti-Bacterial Agents; Humans; Streptococcal Infections; Streptococcus; Tetracycline; Tetracycline Resistance

Topics: Anti-Bacterial Agents; Oleandomycin; Otolaryngology; Staphylococcal Infections; Streptococcal Infections; Tetracycline

Topics: Child; Disease Outbreaks; Humans; Infant; Pharyngitis; Streptococcal Infections; Streptococcus; Tetracycline