Berbel Dàmaris, González-Díaz Aida, López de Egea Guillem, Càmara Jordi, Ardanuy Carmen
Microbiology Department, Hospital Universitari de Bellvitge, IDIBELL-UB, 08907 Barcelona, Spain.
Research Network for Respiratory Diseases (CIBERES), ISCIII, 28020 Madrid, Spain.
Microorganisms. 2022 Nov 23;10(12):2316. doi: 10.3390/microorganisms10122316.
Streptococcal infections are usually treated with beta-lactam antibiotics, but, in case of allergic patients or reduced antibiotic susceptibility, macrolides and fluoroquinolones are the main alternatives. This work focuses on studying macrolide resistance rates, genetic associated determinants and antibiotic consumption data in Spain, Europe and also on a global scale. Macrolide resistance (MR) determinants, such as ribosomal methylases ((B), (TR), (T)) or active antibiotic efflux pumps and ribosomal protectors ((A/E)-(D)), are differently distributed worldwide and associated with different clonal lineages and mobile genetic elements. MR rates vary together depending on clonal dynamics and on antibiotic consumption applying selective pressure. Among , higher MR rates are found in the viridans group, and , and lower MR rates are described in . When considering different geographic areas, higher resistance rates are usually found in East-Asian countries and milder or lower in the US and Europe. Unfortunately, the availability of data varies also between countries; it is scarce in low- and middle- income countries from Africa and South America. Thus, surveillance studies of macrolide resistance rates and the resistance determinants involved should be promoted to complete global knowledge among macrolide resistance dynamics.
链球菌感染通常用β-内酰胺类抗生素治疗，但对于过敏患者或抗生素敏感性降低的情况，大环内酯类和氟喹诺酮类是主要的替代药物。这项工作重点研究西班牙、欧洲以及全球范围内的大环内酯类耐药率、相关遗传决定因素和抗生素消费数据。大环内酯类耐药（MR）决定因素，如核糖体甲基化酶（（B）、（TR）、（T））或活性抗生素外排泵和核糖体保护蛋白（（A/E）-（D）），在全球范围内分布不同，并与不同的克隆谱系和移动遗传元件相关。MR率根据克隆动态和施加选择压力的抗生素消费情况而共同变化。在[具体内容缺失]中，在草绿色链球菌群、[具体内容缺失]和[具体内容缺失]中发现较高的MR率，而在[具体内容缺失]中描述的MR率较低。当考虑不同地理区域时，东亚国家通常发现较高的耐药率，而美国和欧洲则较低或温和。不幸的是，各国之间数据的可获得性也有所不同；非洲和南美洲的低收入和中等收入国家数据稀缺。因此，应推动对大环内酯类耐药率及相关耐药决定因素的监测研究，以完善全球对大环内酯类耐药动态的认识。
