Yayah Winarti, Indonesia
Eijkman Institute Molecular Bacteriology UnitPresenter of 1 Presentation
ANALYSIS OF ERMB AND MEFA GENES FROM NON-SUSCEPTIBLE ERYTHROMYCIN STREPTOCOCCUS PNEUMONIAE ISOLATES IN INDONESIA (ID 564)
Abstract
Background
Macrolide resistance of Streptococcus pneumoniae has already increased in worldwide. In Asia, >70% of clinical S. pneumoniae isolates was reported as erythromycin resistant. ErmB and mefA genes existence plays a role in resistance mechanism by modification of drug binding site and active efflux of the cell. This study is aimed to analyze macrolide resistant genes (ermB and mefA) associated with prevalence of non-susceptible erythromycin S. pneumoniae isolates in Indonesia.
Methods
Seventy isolates of S. pneumoniae were processed for antimicrobial susceptibility testing according to CLSI. The ermB and mefA genes were detected using duplex PCR. Association between these genes and erythromycin resistance rate was analyzed using Fisher test.
Results
A total of 47 (67%) isolates were nonsusceptible to erythromycin. ErmB was detected in 24 (34.2%) isolates and mefA was detected in 50 (71.4%) isolates. Isolates having both ermB and mefA were 34 (48.5%) isolates. There was association between erythromycin resistance with existence of mefA gene (P < 0.001), ermB (P = 0,045) and both (P = 0,036). The most common resistance isolates were serotype 19F (38,2%) and 23F (31,9%).
Conclusions
The existence of mefA and ermB seems to be associated with erythromycin non-susceptible of S. pneumoniae where mefA is the most associated to resistance.
Author Of 2 Presentations
PRELIMINARY RESULTS OF PCV-13 IMPACT STUDY IN HIV-INFECTED PATIENTS IN INDONESIA (ID 893)
Abstract
Background
Reduction in vaccine-type S. pneumoniae carriage can potentially reduce the risk of pneumococcal infection. However, the efficacy of the vaccine in HIV-infected individuals are still debatable.
Methods
HIV-infected patients (n=50) with mean age of 11.3 (6.4-16.8) years old in Jakarta were randomly enrolled into two groups. One group received a single dose of PCV-13 while the control group did not receive PCV-13. Nasopharyngeal (NP) swabs were collected to evaluate the impact of PCV-13 vaccination on S. pneumoniae colonization. The study will follow both groups until 18 months after the vaccination to find the difference of colonization and pneumococcal antibody in both groups at 6, 12, and 18 months period. This abstract reported the first phase of our study.
Results
We found 46% of NP swabs collected at initial phase were positive for S. pneumoniae with no significant difference in carriage rates between control and treatment group (p=0.917). We evaluate potential risk factors and found that school attendance significantly associated to colonization of S. pneumoniae in treatment group with p value = 0.015.
Conclusions
This result provides baseline data for pneumococcal vaccine evaluation in HIV-infected patients. We found 46% subjects were carrier for S. pneumonia and it was at the similar rate as previous studies.
ANALYSIS OF ERMB AND MEFA GENES FROM NON-SUSCEPTIBLE ERYTHROMYCIN STREPTOCOCCUS PNEUMONIAE ISOLATES IN INDONESIA (ID 564)
Abstract
Background
Macrolide resistance of Streptococcus pneumoniae has already increased in worldwide. In Asia, >70% of clinical S. pneumoniae isolates was reported as erythromycin resistant. ErmB and mefA genes existence plays a role in resistance mechanism by modification of drug binding site and active efflux of the cell. This study is aimed to analyze macrolide resistant genes (ermB and mefA) associated with prevalence of non-susceptible erythromycin S. pneumoniae isolates in Indonesia.
Methods
Seventy isolates of S. pneumoniae were processed for antimicrobial susceptibility testing according to CLSI. The ermB and mefA genes were detected using duplex PCR. Association between these genes and erythromycin resistance rate was analyzed using Fisher test.
Results
A total of 47 (67%) isolates were nonsusceptible to erythromycin. ErmB was detected in 24 (34.2%) isolates and mefA was detected in 50 (71.4%) isolates. Isolates having both ermB and mefA were 34 (48.5%) isolates. There was association between erythromycin resistance with existence of mefA gene (P < 0.001), ermB (P = 0,045) and both (P = 0,036). The most common resistance isolates were serotype 19F (38,2%) and 23F (31,9%).
Conclusions
The existence of mefA and ermB seems to be associated with erythromycin non-susceptible of S. pneumoniae where mefA is the most associated to resistance.