doiSerbia

The prevalence of resistance to macrolides and lincosamides among community- and hospital- acquired staphylococci and streptococci isolates in southeast Serbia

Mišić Milena (Public Health Institute Vranje, Department of Microbiology, Vranje)
Arsović Aleksandra (Faculty of Medical Sciences, Institute of Medical Microbiology and Immunology, Kosovska Mitrovica)
Čukić Jelena (Department of Clinical Microbiology, Laboratory for Virology, Serology, Immunology and Molecular diagnostics, Public Health Institute Kragujevac, Kragujevac)
Rosić Milenko I. (University Clinic of Cardiovascular Surgery Sremska Kamenica, Institute for Cardiovascular Diseases of Vojvodina, Novi Sad)
Tošić-Pajić Jelena (Faculty of Medical Sciences, Kragujevac, Doctoral Academic Study)
Manojlović Nevena (Faculty of Medical Sciences, Kragujevac, Doctoral Academic Study)
Čekerevac Ivan (Faculty of Medical Sciences, Department of Internal medicine, Kragujevac + Clinical Centre Kragujevac, Pulmonology Clinic, Kragujevac)
Vidanović Dejan (Veterinary Specialized Institute Kraljevo, Department of Laboratory Diagnostics, National Reference Laboratory for Avian Influenza and Newcastle disease of poultry Republic of Serbia, Kraljevo)
Šekler Milanko (Veterinary Specialized Institute Kraljevo, Department of Laboratory Diagnostics, National Reference Laboratory for Avian Influenza and Newcastle disease of poultry Republic of Serbia, Kraljevo)
Baskić Dejan (Department of Clinical Microbiology, Laboratory for Virology, Serology, Immunology and Molecular diagnostics, Public Health Institute Kragujevac, Kragujevac + Faculty of Medical Sciences, Center for Molecular Medicine and Stem Cell Research, Department of)

Introduction/Objective. The increasing resistance to macrolides and lincosamides among staphylococci and streptococci is becoming a global problem. The aim of this study was to investigate the prevalence of macrolide-lincosamide-streptogramin (MLS) resistance phenotypes in staphylococcal and streptococcal isolates in southeast Serbia. Methods. The MLS phenotypes were determined by the double-disk diffusion method in 2,121 inpatient and outpatient staphylococcal and streptococcal isolates collected during a one-year period at the Center for Microbiology. Results. The methicillin-resistant staphylococci isolates were significantly more resistant to penicillin, erythromycin, clindamycin, gentamicin, and ciprofloxacin (100%, 100%, 29.2%, 65.6%, and 53.1%, respectively) than the methicillin-sensitive ones (93.6%, 64.9%, 12%, 28.9%, and 11.7%, respectively). The inducible clindamycin resistance phenotype was dominant in S. aureus and coagulase-negative staphylococci isolates. S. pneumoniae, S. pyogenes, and S. agalactiae isolates showed very high resistance to erythromycin (77.8%, 46.2%, and 32.4%, respectively). All staphylococci and streptococci isolates were sensitive to vancomycin and linezolid, and all beta-hemolytic streptococci isolates to penicillin and ceftriaxone. Conclusion. The phenotypic triage of staphylococci is necessary in order to separate inducible resistant and truly clindamycin-sensitive isolates. Macrolides should not be recommended for empirical therapy of streptococcal infections. Penicillins remain the drug of choice for treatment of streptococcal infections in our local area.

Keywords: staphylococci, streptococci, MLS resistance phenotypes, inducible clindamycin resistance

Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. III41010