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Mechanismus rezistence makrolidů a linkosamidů v koaguláze negativních stafylokoků v ČR a nové typy na linkosamid resistentních S. haemolyticus
Novotná, Gabriela ; Janata, Jiří ; Spížek, Jaroslav
Objectives: The aim of this study was to investigate an incidence of different resistance mechanisms to macrolides and lincosamides in methicillin-resistant coagulase-negative staphylococci in the Czech Republic. Methods: Phenotypes were determined by triple-disc diffusion method. The presence of the genes ermA, ermC (resistance by target site alteration) msrA (efflux resistance) and linA (resistance by antibiotic inactivation) was tested by Southern blot analysis. A bioassay for the detection of lincomycin inactivation mechanism was performed in lincosamide-resistant strains, where none of the resistance genes was detected. In these strains also PFGE analysis was done. Results: In 99 clinical isolates in vitro resistant to one of erythromycin, lincomycin or clindamycin, triple-disc diffusion method reveals seven different phenotypes corresponding with resistance mechanisms. The resistance was mainly due to the presence of msrA gene, which was detected in 53 strains. Genes ermC and ermA were detected in 42 strains and the linA was detected in 28 strains. In 15 lincosamides-resistant strains no resistance gene was detected. Lincosamides were not inactivated in those strains indicating a new type of resistance different from inactivation. Conclusion: The dissemination of resistance types differs strongly from the published data. While in other countries cross-resistance to macrolides and lincosamides conferred by ermA and ermC predominates, in the Czech Republic the gene msrA is the most frequent genetic determinant conferring resistance to macrolides only. It follows that one third of macrolide-resistant staphylococci remains lincosamide-sensitive. A homogenous group of lincosamide-resistant S. haemolyticus with unknown resistance mechanism was newly defined.

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