Elementos genéticos móviles asociados con resistencia a eritromicina en aislamientos de Streptococcus pneumoniae en Colombia

Abstract

Resistance to macrolide antibiotics is increasing in clinical isolates of Streptococcus pneumoniae and is associated with the presence of mobile genetic elements. Objetive: The aim of this study was to determine the distribution of serotypes and transposons among macrolide-resistant invasive isolates of S. pneumoniae in Colombia from 1994 to 2011.A total of 225 macrolide-resistant S. pneumoniae isolates were analyzed. The isolates had epidemiological data, serotyping and antimicrobial susceptibility patterns. The phenotypes were tested by erythromycin-clindamycin double-disk test. We investigated the presence of transposons by several multiplex PCRs to identify the genes erm (B), mef(A), mef(E), tet M, Cat , Aph3 -III, int -Tn 916 , xis -Tn 916 , TnpA -Tn 917 , TnpR -Tn 917 and int -Tn 5252 .Of all isolates, 62.7%, 2.7% and 34.6% of isolates exhibited cMLS B, iMLS B, and M phenotypes, respectively. Multiresistance was observed in 69.3% of these strains. The most prevalent genetic elements in MLS B were the Tn 5253 (34%), mostly carried in serotype 6B isolates and found to be related to the international clone Spain-ST90; Tn 1545 (18.4%), carried by serotype 19A and related to ST276, and Tn 3872 (14.9%), mainly detected in capsular types 6B and 14. Other seven transposons (32.7%) were associated with different serotypes. The mega element (62.8%) was associated to serotype 6A and ST473 in M phenotype.The majority of erythromycin-resistance isolates of S. pneumoniae in Colombia had the cMLS B phenotype and was associated with the presence of transposons, which carry multiple resistance determinants for other antibiotics. Moreover, isolates with M phenotype carried the gene mef( E) in the mega element.