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. 2023 Feb 8;76(3):e1266-e1269.
doi: 10.1093/cid/ciac468.

Continued Increase of Erythromycin Nonsusceptibility and Clindamycin Nonsusceptibility Among Invasive Group A Streptococci Driven by Genomic Clusters, United States, 2018-2019

Yuan Li  1 , Joy Rivers  1 , Saundra Mathis  1 , Zhongya Li  1 , Lesley McGee  1 , Sopio Chochua  1 , Benjamin J Metcalf  1 , Katherine E Fleming-Dutra  1 , Srinivas A Nanduri  1 , Bernard Beall  1
Affiliations

Continued Increase of Erythromycin Nonsusceptibility and Clindamycin Nonsusceptibility Among Invasive Group A Streptococci Driven by Genomic Clusters, United States, 2018-2019

Yuan Li et al. Clin Infect Dis. .

Abstract

We analyzed 9630 invasive GAS surveillance isolates in the USA. From 2015-2017 to 2018-2019, significant increases in erythromycin-nonsusceptibility (18% vs 25%) and clindamycin-nonsusceptibility (17% vs 24%) occurred, driven by rapid expansions of genomic subclones. Prevention and control of clustered infections appear key to containing antimicrobial resistance.

Keywords: antimicrobial resistance; genomic cluster; group A Streptococcus; invasive disease.

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Conflict of interest statement

Potential conflicts of interest. All authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
Increase of erythromycin nonsusceptibility and clindamycin nonsusceptibility among invasive group A streptococci, United States, 2018–2019. A, Proportions of isolates that were EryNS, CliNS, or coresistant to both (EryNS + CliNS). The total number of isolates used for proportion calculations is shown for each year. B, Proportions of isolates that were positive for resistant gene targets ermB, ermT, ermTR, or mef. C, Proportions of isolates that were EryNS and clustered (EryNS_Clustered), EryNS and nonclustered (EryNS_Non-Clustered), EryS and clustered (EryS_Clustered), and EryNS and nonclustered (EryNS_NonClustered). See text for details. D, Similar to (C) except reporting the proportions for clindamycin. ***, P < .001 for trend test; *, P < .05; ns, P > .05. Abbreviations: CliNS, clindamycin nonsusceptible; EryNS, erythromycin nonsusceptible.
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