Heterogeneity of macrolide-lincosamide-streptogramin B resistance phenotypes in enterococci

Antimicrob Agents Chemother. 2003 Nov;47(11):3415-20. doi: 10.1128/AAC.47.11.3415-3420.2003.

Abstract

We determined the macrolide resistance phenotypes of 241 clinical isolates of erythromycin-resistant enterococci (MICs, > or = 1 microg/ml), including 147 Enterococcus faecalis strains and 94 Enterococcus faecium strains, collected from a hospital in Seoul, Korea, between 1999 and 2000. By the erythromycin (40 micro g)-josamycin (100 microg) double-disk test, 93 strains were assigned to the constitutive macrolide, lincosamide, and streptogramin B (MLS(B)) resistance (cMLS(B)) phenotype, and the remaining 148 strains were assigned to the inducible MLS(B) resistance (iMLS(B)) phenotype. Of the strains with the iMLS(B) phenotype, 36 exhibited a reversibly inducible MLS(B) (riMLS(B)) phenotype, i.e., blunting of the erythromycin zone of inhibition, which indicates that the 16-membered-ring macrolide josamycin is a more effective inducer than the 14-membered-ring macrolide erythromycin. Sequence analysis of the regulatory regions of the erm(B) genes from all of the strains exhibiting the riMLS(B) phenotype revealed not only erm(Bv) [where v represents variant; previously erm(AMR)] (n = 13), as reported previously, but also three kinds of erm(B) variants, which were designated erm(Bv1) (n = 17), erm(Bv2) (n = 3), and erm(Bv3) (n = 3), respectively. In lacZ reporter gene assays of these variants, the 16-membered-ring macrolide tylosin had stronger inducibility than erythromycin at > or = 0.1 microg/ml. These findings highlight the versatility of erm(B) in induction specificity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Base Sequence
  • Drug Resistance, Bacterial
  • Enterococcus faecalis / drug effects*
  • Enterococcus faecalis / growth & development
  • Enterococcus faecium / drug effects*
  • Enterococcus faecium / growth & development
  • Lac Operon / genetics
  • Lincosamides
  • Macrolides / pharmacology*
  • Microbial Sensitivity Tests
  • Molecular Sequence Data
  • Phenotype
  • Plasmids / genetics
  • Streptogramin B / pharmacology*
  • beta-Galactosidase / biosynthesis

Substances

  • Anti-Bacterial Agents
  • Lincosamides
  • Macrolides
  • Streptogramin B
  • beta-Galactosidase