Antimicrobial resistance rates of Streptococcus pyogenes in a Greek tertiary care hospital: 6-year data and literature review

Abstract

Streptococcus pyogenes is responsible for various clinical manifestations in patients of all ages worldwide. Worryingly, an increase in antibiotic resistance rates of S. pyogenes has been observed in many countries. In the present study, 6-year data are presented regarding the antibiotic resistance rates of S. pyogenes in our hospital. During this period, a total of 52 S. pyogenes isolates were recovered from 52 patients and antimicrobial susceptibility testing was performed for 49 isolates. All were susceptible to penicillin, ampicillin, cefotaxime, ceftriaxone, linezolid, moxifloxacin, rifampicin, vancomycin, teicoplanin, and tigecycline. Erythromycin and clindamycin resistance rates were 20.4% and 18.8% respectively. Resistance rates to tetracycline were 40.8%, to chloramphenicol 6.9%, and to levofloxacin 2%. Since macrolides are recommended as an alternative treatment in case of allergy to β-lactams, the high macrolide resistance rates are causing concern. Because different phenotypic antimicrobial patterns for S. pyogenes have been observed in different geographic areas, epidemiological data is of considerable value for the appropriate treatment choices.

Keywords: Streptococcus pyogenes; macrolides; β-lactams.