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Medicinski podmladak
2018, vol. 69, br. 1, str. 65-69
jezik rada: srpski
vrsta rada: izvorni naučni članak
doi:10.5937/mp69-13820

Creative Commons License 4.0
Izmena fenotipova rezistencije na makrolide kod faringealnih sojeva streptokoka grupe a u dečijoj populaciji
aUniverzitet u Beogradu, Medicinski fakultet
bUniverzitet u Beogradu, Medicinski fakultet, Institut za mikrobiologiju i imunologiju

e-adresa: pavlius3@yahoo.com

Sažetak

Uvod: Za lečenje faringitisa izazvanog bakterijom Streptococcus pyogenes (S.pyogenes; grupa A streptokoka - GAS) se, pored penicilina, često koriste i makrolidi. U Srbiji je u prethodnom periodu rezistencija GAS na eritromicin bila umereno visoka. Cilj: Cilj ovog rada je bio da se ispita da li je u 2016. - 2017. godini došlo do izmena u incidenciji i fenotipovima rezistencije faringealnih izolata GAS na makrolide u odnosu na raniji period. Materijal i metode: Istraživanje je obuhvatilo 107 sojeva GAS izolovanih od dece obolele od faringitisa u dvoipomesečnom periodu tokom 2016. - 2017. godine, u Beogradu. Osetljivost izolata na antibiotike je ispitana disk difuzionom metodom antibiograma; fenotipovi rezistencije na makrolide D testom, a vrednost minimalnih inhibitornih koncentracija (MIK) eritromicina i klindamicina je određena E testom. Podaci iz ovog istraživanja su upoređeni sa rezultatima koji su dobijeni prethodnih godina. Rezultati: Rezistencija na eritromicin je uočena kod 6,5% izolata, što predstavlja pad u odnosu na period između 2008. - 2009. godine. Došlo je i do promene dominantnog fenotipa makrolidne rezistencije - dok je u prethodnom periodu najčešći bio M fenotip, sada je to cMLSb (71,4%). Pored rezistencije na eritromicin, primećena je i rezistencija i na: trimetoprim + sulfametoksazol (98,1%), klindamicin (4,7%) i tetracikline (2,8%). Zaključak: Iako je kod nas, u odnosu na raniji period, došlo do pada stope rezistencije faringealnih izolata S.pyogenes na makrolide, i dalje je nivo rezistencije iznad proseka u regionu. Niskorezistentni M fenotip, koji je bio dominantan 2008. - 2009. godine je zamenio visokorezistentni MLS. Kako bi se pratile promene u dinamičnoj populaciji GAS, neophodno je dalje kontinuirano praćenje rezistencije i fenotipa rezistencije GAS na makrolide.

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Reference

Bingen, E., Fitoussi, F., Doit, C., Cohen, R., Tanna, A., George, R., Loukil, C., Brahimi, N., le Thomas, I., Deforche, D. (2000) Resistance to Macrolides in Streptococcus pyogenes in France in Pediatric Patients. Antimicrobial Agents and Chemotherapy, 44(6): 1453-1457
Bisno, A.L., Gerber, M.A., Gwaltney, J.M., Kaplan, E.L., Schwartz, R.H. (2002) Practice guidelines for the diagnosis and management of group A streptococcal pharyngitis. Infectious Diseases Society of America. Clin Infect Dis, 35(2): 113-25
Detcheva, A., Facklam, R.R., Beall, B. (2002) Erythromycin-resistant group A streptococcal isolates recovered in Sofia, Bulgaria, from 1995 to 2001. J Clin Microbiol, 40, str. 3831-3834
Dorobat, O.M., Badicut, I., Talapan, D., Tenea, C., Rafila, A. (2010) Antibiotic resistance of Gram-positive cocci isolated in 2008. Bacteriol Virusol Parazitol Epidemiol, Apr-; Jun; 55(2); 83-92
Dundar, D., Sayan, M., Tamer, G.S. (2010) Macrolide and Tetracycline Resistance and emm Type Distribution of Streptococcus pyogenes Isolates Recovered from Turkish Patients. Microbial Drug Resistance, 16(4): 279-284
European Committee on Antimicrobial Susceptibility Testing (2017) Disk diffusion method for antimicrobial susceptibility testing. Version 6.0, http://www.eucast.org
European Committee on Antimicrobial Susceptibility Testing (2017) Breakpoint tables for interpretation of MICs and zone diameters. Version 7.0, http://www.eucast.org
Friães, A., Pinto, F.R., Silva-Costa, C., Ramirez, M., Melo-Cristino, J. (2012) Group A streptococci clones associated with invasive infections and pharyngitis in Portugal present differences in emm types, superantigen gene content and antimicrobial resistance. BMC Microbiology, 12(1): 280
Gattringer, R., Sauermann, R., Lagler, H., Stich, K., Buxbaum, A., Graninger, W., i dr. (2004) Antimicrobial susceptibility and macrolide resistance genes in Streptococcus pyogenes colleceted in Austria and Hungary. Int J Antimicrob Agents, 24:290-293
Giovanetti, E., Brenciani, A., Lupidi, R., Roberts, M.C., Varaldo, P.E. (2003) Presence of the tet(O) Gene in Erythromycin- and Tetracycline-Resistant Strains of Streptococcus pyogenes and Linkage with either the mef(A) or the erm(A) Gene. Antimicrobial Agents and Chemotherapy, 47(9): 2844-2849
Kataja, J., Huovinen, P., Skurnik, M. (1999) Erythromycin Resistance Genes in Group A Streptococci in Finland. Antimicrob Agents Chemother, Jan; 43(1); 48-52
Michos, A., Koutouzi, F.I., Tsakris, A., Chatzichristou, P., Koutouzis, E.I., Daikos, G.L., Stathi, A., Syriopoulou, V.P. (2016) Molecular analysis of Streptococcus pyogenes macrolide resistance of paediatric isolates during a 7 year period (2007-13). Journal of Antimicrobial Chemotherapy, 71(8): 2113-2117
Montes, M., Tamayo, E., Mojica, C., Garcia-Arenzana, J.M., Esnal, O., Perez-Trallero, E. (2014) What causes decreased erythromycin resistance in Streptococcus pyogenes? Dynamics of four clones in a southern European region from 2005 to 2012. Journal of Antimicrobial Chemotherapy, 69(6): 1474-1482
Opavski, N., Gajic, I., Borek, A.L., Obszańska, K., Stanojevic, M., Lazarevic, I., Ranin, L., Sitkiewicz, I., Mijac, V. (2015) Molecular characterization of macrolide resistant Streptococcus pyogenes isolates from pharyngitis patients in Serbia. Infection, Genetics and Evolution, 33: 246-252
Ranin, L., Opavski, N., Djukic, S., Mijac, V. (1991-1999) Epidemiology of diseases caused by Streptococcus pyogenes in Serbia during a nine-year period. Indian J Med Res., 119 Suppl; May; 155-9; 2004
Richter, S.S., Heilmann, K.P., Dohrn, C.L., Beekmann, S.E., Riahi, F., Garcia-de-Lomas, J., Ferech, M., Goossens, H., Doern, G.V. (2008) Increasing telithromycin resistance among Streptococcus pyogenes in Europe. Journal of Antimicrobial Chemotherapy, 61(3): 603-611
Rubio-López, V., Valdezate, S., Álvarez, D., Villalón, P., Medina, M., Salcedo, C., Sáez-Nieto, J. (2012) Molecular epidemiology, antimicrobial susceptibilities and resistance mechanisms of Streptococcus pyogenes isolates resistant to erythromycin and tetracycline in Spain (1994-2006). BMC Microbiology, 12(1): 215
Seppälä, H., Nissinen, A., Yu, Q., Huovinen, P. (1993) Three different phenotypes of erythromycin-resistant Streptococcus pyogenes in Finland. Journal of Antimicrobial Chemotherapy, 32(6): 885-891
Shaikh, N., Leonard, E., Martin, J.M. (2010) Prevalence of Streptococcal Pharyngitis and Streptococcal Carriage in Children: A Meta-analysis. Pediatrics, 126(3): e557-e564
Silva-Costa, C., Pinto, F.R., Ramirez, M., Melo-Cristino, J. (2008) Decrease in macrolide resistance and clonal instability among Streptococcus pyogenes in Portugal. Clinical Microbiology and Infection, 14(12): 1152-1159
Tapia, M.D., Sow, S.O., Tamboura, B., Keita, M.M., Berthe, A., Samake, M., Nataro, J.P., Onwuchekwa, U.O., Penfound, T.A., Blackwelder, W., Dale, J.B., Kotloff, K.L. (2015) Streptococcal Pharyngitis in Schoolchildren in Bamako, Mali. Pediatric Infectious Disease Journal, 34(5): 463-468
Versporten, A., Bolokhovets, G., Ghazaryan, L., Abilova, V., Pyshnik, G., Spasojevic, T., Korinteli, I., Raka, L., Kambaralieva, B., Cizmovic, L., Carp, A., Radonjic, V., Maqsudova, N., Celik, H.D., Payer (2014) Antibiotic use in eastern Europe: a cross-national database study in coordination with the WHO Regional Office for Europe. Lancet Infectious Diseases, 14(5): 381-387