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Titolo:
Macrolide resistance and Streptococcus pyogenes: Molecular basis, epidemiology and clinical significance
Autore:
Cornaglia, G;
Indirizzi:
Univ Verona, Ist Microbiol, I-37134 Verona, Italy Univ Verona Verona Italy I-37134 a, Ist Microbiol, I-37134 Verona, Italy
Titolo Testata:
REVIEWS IN MEDICAL MICROBIOLOGY
fascicolo: 4, volume: 10, anno: 1999,
pagine: 245 - 258
SICI:
0954-139X(199910)10:4<245:MRASPM>2.0.ZU;2-K
Fonte:
ISI
Lingua:
ENG
Soggetto:
GROUP-A STREPTOCOCCI; ERYTHROMYCIN RESISTANCE; NUCLEOTIDE-SEQUENCE; PENICILLIN-V; SUSCEPTIBILITY; ANTIBIOTICS; PHARYNGITIS; PNEUMONIAE; CHILDREN; PLASMID;
Keywords:
Streptococcus pyogenes; macrolide; antimicrobial resistance; upper respiratory tract infection;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
61
Recensione:
Indirizzi per estratti:
Indirizzo: Cornaglia, G Univ Verona, Ist Microbiol, Strada Le Grazie 8, I-37134 Verona, Italy Univ Verona Strada Le Grazie 8 Verona Italy I-37134 a, Italy
Citazione:
G. Cornaglia, "Macrolide resistance and Streptococcus pyogenes: Molecular basis, epidemiology and clinical significance", REV MED MIC, 10(4), 1999, pp. 245-258

Abstract

Over the past few years, increased rates of erythromycin resistance have been reported for Streptococcus pyogenes (group A beta-haemolytic Streptococcus). This is often related to the increased clinical use of erythromycin and its newer derivatives, mostly in upper respiratory tract infections. Molecular mechanisms that mediate macrolide resistance include target site modification, which affect macrolide, lincosamide and streptogramin B antibiotics, resulting in the 'MLSB' phenotype which is either constitutive or inducible. The intracellular macrolide concentration may also be reduced by active efflux, a mechanism that affects only macrolides, responsible for the 'M' phenotype. Even though occasional local outbreaks of resistant strains have been reported in various parts of the world, not counting the major outbreaks in Japan and Finland, the occurrence of such strains was considered exceptional until only a few years ago. Until then, S. pyogenes isolates were considered basically susceptible to macrolides. In the mid-1990s a new outbreak in Italy was noted just before a more generalised, and still active, upsurge in erythromycin resistance in Europe, The highest proportions of resistance were observed in southern countries and the lowest in northern countries of Europe, and molecular studies showed a substantial prevalence of the M phenotype. Although the present epidemiological situation amounts to the first large-scale crisis in macrolide susceptibility of streptococci,awareness of this new antimicrobial resistance problem appears to be limited in general, and the impact of in-vitro resistance on clinical practice has also been questioned. (C) 1999 Lippincott Williams & Wilkins.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 20/10/20 alle ore 05:16:26