Investigation of inducible clindamycin and telithromycin resistance in isolates of beta-hemolytic streptococci

Diagn Microbiol Infect Dis. 2006 Jul;55(3):213-8. doi: 10.1016/j.diagmicrobio.2006.01.013. Epub 2006 Mar 20.

Abstract

We evaluated the accuracy of an erythromycin-clindamycin double-disk test (D-zone test) and an erythromycin-telithromycin D-zone test for detection of inducible resistance in isolates of beta-hemolytic streptococci with erythromycin resistance. The results of these tests were compared to results of a broth microdilution (BMD) induction test using combinations of erythromycin and either clindamycin or telithromycin. Of 29 erythromycin-resistant, clindamycin-susceptible isolates, 16 were positive by the erythromycin-clindamycin D-zone test; all of these demonstrated inducible clindamycin resistance by BMD. Twelve isolates were D-zone test-negative, did not demonstrate inducible resistance by BMD, and were positive for a mef determinant. Of 39 erythromycin-resistant, telithromycin-susceptible isolates, 13 were erythromycin-telithromycin D-zone test-positive, 19 questionably positive (unclear blunting of the zone), and 7 were D-zone test-negative. The erythromycin-telithromycin D-zone test result did not correlate with inducible resistance by BMD or the presence of an erm or mef gene. These results demonstrate that the erythromycin-clindamycin D-zone and BMD induction tests accurately detect inducible clindamycin resistance, but the erythromycin-telithromycin D-zone test is not reliable for detecting inducible telithromycin resistance.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Bacterial Proteins / genetics*
  • Bacterial Proteins / metabolism
  • Clindamycin / pharmacology
  • Drug Resistance, Bacterial / genetics*
  • Hemolysin Proteins
  • Humans
  • Ketolides / pharmacology
  • Macrolides / pharmacology
  • Membrane Proteins / genetics*
  • Methyltransferases / genetics*
  • Microbial Sensitivity Tests / methods
  • Streptococcus / drug effects
  • Streptococcus / genetics*

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • Hemolysin Proteins
  • Ketolides
  • Macrolides
  • MefA protein, Streptococcus
  • Membrane Proteins
  • streptococcal group B hemolysin
  • Clindamycin
  • Methyltransferases
  • ErmA protein, Bacteria
  • telithromycin