Emerging Threat of Antimicrobial Resistance in β-Hemolytic Streptococci
Highly variable resistance rates to erythromycin and clindamycin have been reported in the β-hemolytic streptococcal species Streptococcus pyogenes, Streptococcus agalactiae, and Streptococcus dysgalactiae, depending on geographic and temporal context. In the present study we aimed to examine the lo...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-05-01
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| Series: | Frontiers in Microbiology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fmicb.2020.00797/full |
| _version_ | 1818322990551531520 |
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| author | Oddvar Oppegaard Steinar Skrede Haima Mylvaganam Bård Reiakvam Kittang |
| author_facet | Oddvar Oppegaard Steinar Skrede Haima Mylvaganam Bård Reiakvam Kittang |
| author_sort | Oddvar Oppegaard |
| collection | DOAJ |
| description | Highly variable resistance rates to erythromycin and clindamycin have been reported in the β-hemolytic streptococcal species Streptococcus pyogenes, Streptococcus agalactiae, and Streptococcus dysgalactiae, depending on geographic and temporal context. In the present study we aimed to examine the longitudinal trends of antimicrobial resistance in these three species in a northern European setting. Furthermore, we used whole genome sequencing to identify resistance determinants and the mobile genetic elements involved in their dissemination, as well as elucidate phylogenetic relationships. All cases of invasive β-hemolytic streptococcal diseases in Health Region Bergen, western Norway, in the period 2004 to 2018 were retrospectively identified, comprising 271, 358, and 280 cases of S. pyogenes, S. agalactiae, and S. dysgalactiae, respectively. Antimicrobial susceptibility testing revealed a gradual but significant increase in erythromycin and clindamycin resistance for S. agalactiae and S. dysgalactiae during the study period. Whole genome sequencing of the erythromycin and clindamycin resistant bacterial population revealed a substantial phylogenetic diversity in S. agalactiae and S. dysgalactiae. However, the mobile genetic elements harboring the resistance determinants showed remarkable intra- and interspecies similarities, suggesting a dissemination of antimicrobial resistance predominantly through conjugative transfer rather than clonal expansion of resistant strains in these two species. Conversely, antimicrobial resistance in S. pyogenes remained low, apart from a transient outbreak of a clindamycin and erythromycin resistant emm11/ST403-clone in 2010–2012. Increased epidemiological attentiveness is warranted to monitor the emerging threat of antimicrobial resistance in β-hemolytic streptococci, particularly in S. agalactiae and S. dysgalactiae. |
| first_indexed | 2024-12-13T11:05:35Z |
| format | Article |
| id | doaj.art-e6fe58e314394084972878b5386beecb |
| institution | Directory Open Access Journal |
| issn | 1664-302X |
| language | English |
| last_indexed | 2024-12-13T11:05:35Z |
| publishDate | 2020-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Microbiology |
| spelling | doaj.art-e6fe58e314394084972878b5386beecb2022-12-21T23:49:01ZengFrontiers Media S.A.Frontiers in Microbiology1664-302X2020-05-011110.3389/fmicb.2020.00797530624Emerging Threat of Antimicrobial Resistance in β-Hemolytic StreptococciOddvar Oppegaard0Steinar Skrede1Haima Mylvaganam2Bård Reiakvam Kittang3Department of Medicine, Haukeland University Hospital, Bergen, NorwayDepartment of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, NorwayDepartment of Microbiology, Haukeland University Hospital, Bergen, NorwayDepartment of Medicine, Haraldsplass Deaconess Hospital, Bergen, NorwayHighly variable resistance rates to erythromycin and clindamycin have been reported in the β-hemolytic streptococcal species Streptococcus pyogenes, Streptococcus agalactiae, and Streptococcus dysgalactiae, depending on geographic and temporal context. In the present study we aimed to examine the longitudinal trends of antimicrobial resistance in these three species in a northern European setting. Furthermore, we used whole genome sequencing to identify resistance determinants and the mobile genetic elements involved in their dissemination, as well as elucidate phylogenetic relationships. All cases of invasive β-hemolytic streptococcal diseases in Health Region Bergen, western Norway, in the period 2004 to 2018 were retrospectively identified, comprising 271, 358, and 280 cases of S. pyogenes, S. agalactiae, and S. dysgalactiae, respectively. Antimicrobial susceptibility testing revealed a gradual but significant increase in erythromycin and clindamycin resistance for S. agalactiae and S. dysgalactiae during the study period. Whole genome sequencing of the erythromycin and clindamycin resistant bacterial population revealed a substantial phylogenetic diversity in S. agalactiae and S. dysgalactiae. However, the mobile genetic elements harboring the resistance determinants showed remarkable intra- and interspecies similarities, suggesting a dissemination of antimicrobial resistance predominantly through conjugative transfer rather than clonal expansion of resistant strains in these two species. Conversely, antimicrobial resistance in S. pyogenes remained low, apart from a transient outbreak of a clindamycin and erythromycin resistant emm11/ST403-clone in 2010–2012. Increased epidemiological attentiveness is warranted to monitor the emerging threat of antimicrobial resistance in β-hemolytic streptococci, particularly in S. agalactiae and S. dysgalactiae.https://www.frontiersin.org/article/10.3389/fmicb.2020.00797/fullβ-hemolytic streptococciantimicrobial resistanceStreptococcus dysgalactiaeStreptococcus pyogenesStreptococcus agalactiae |
| spellingShingle | Oddvar Oppegaard Steinar Skrede Haima Mylvaganam Bård Reiakvam Kittang Emerging Threat of Antimicrobial Resistance in β-Hemolytic Streptococci Frontiers in Microbiology β-hemolytic streptococci antimicrobial resistance Streptococcus dysgalactiae Streptococcus pyogenes Streptococcus agalactiae |
| title | Emerging Threat of Antimicrobial Resistance in β-Hemolytic Streptococci |
| title_full | Emerging Threat of Antimicrobial Resistance in β-Hemolytic Streptococci |
| title_fullStr | Emerging Threat of Antimicrobial Resistance in β-Hemolytic Streptococci |
| title_full_unstemmed | Emerging Threat of Antimicrobial Resistance in β-Hemolytic Streptococci |
| title_short | Emerging Threat of Antimicrobial Resistance in β-Hemolytic Streptococci |
| title_sort | emerging threat of antimicrobial resistance in β hemolytic streptococci |
| topic | β-hemolytic streptococci antimicrobial resistance Streptococcus dysgalactiae Streptococcus pyogenes Streptococcus agalactiae |
| url | https://www.frontiersin.org/article/10.3389/fmicb.2020.00797/full |
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