{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T06:42:48Z","timestamp":1793947368519,"version":"4.8.0"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Microbiol"],"published-print":{"date-parts":[[2012,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Group A <jats:italic>Streptococcus<\/jats:italic> (GAS) causes human diseases ranging in severity from uncomplicated pharyngitis to life-threatening necrotizing fasciitis and shows high rates of macrolide resistance in several countries. Our goal is to identify antimicrobial resistance in Spanish GAS isolates collected between 1994 and 2006 and to determine the molecular epidemiology (<jats:italic>emm<\/jats:italic>\/T typing and PFGE) and resistance mechanisms of those resistant to erythromycin and tetracycline.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Two hundred ninety-five out of 898 isolates (32.8%) were erythromycin resistant, with the predominance of <jats:italic>emm<\/jats:italic> 4T4, <jats:italic>emm<\/jats:italic> 75T25, and <jats:italic>emm<\/jats:italic> 28T28, accounting the 67.1% of the 21 <jats:italic>emm<\/jats:italic>\/T types. Spread of <jats:italic>emm<\/jats:italic> 4T4, <jats:italic>emm<\/jats:italic> 75T25 and <jats:italic>emm<\/jats:italic> 28T28 resistant clones caused high rates of macrolide resistance. The distribution of the phenotypes was M (76.9%), cMLS<jats:sub>B<\/jats:sub> (20.3%), iMLS<jats:sub>B<\/jats:sub> (2.7%) with the involvement of the erythromycin resistance genes <jats:italic>mef<\/jats:italic>(A) (89.5%), <jats:italic>msr<\/jats:italic>(D) (81.7%), <jats:italic>erm<\/jats:italic>(B) (37.3%) and <jats:italic>erm<\/jats:italic>(A) (35.9%).<\/jats:p>\n            <jats:p>Sixty-one isolates were tetracycline resistant, with the main representation of the <jats:italic>emm<\/jats:italic> 77T28 among 20 <jats:italic>emm<\/jats:italic>\/T types. To note, the combination of <jats:italic>tet<\/jats:italic>(M) and <jats:italic>tet<\/jats:italic>(O) tetracycline resistance genes were similar to <jats:italic>tet<\/jats:italic>(M) alone reaching values close to 40%. Resistance to both antibiotics was detected in 19 isolates of 7 <jats:italic>emm<\/jats:italic>\/T types, being <jats:italic>emm<\/jats:italic> 11T11 and the cMLS<jats:sub>B<\/jats:sub> phenotype the most frequent ones. <jats:italic>erm<\/jats:italic>(B) and <jats:italic>tet<\/jats:italic>(M) were present in almost all the strains, while <jats:italic>erm<\/jats:italic>(A), <jats:italic>mef<\/jats:italic>(A), <jats:italic>msr<\/jats:italic>(D) and <jats:italic>tet<\/jats:italic>(O) appeared in less than half of them.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Spanish GAS were highly resistant to macrolides meanwhile showed minor resistance rate to tetracycline. A remarkable correlation between antimicrobial resistance and <jats:italic>emm<\/jats:italic>\/T type was noticed. Clonal spread of <jats:italic>emm<\/jats:italic> 4T4, <jats:italic>emm<\/jats:italic> 75T25 and <jats:italic>emm<\/jats:italic> 28T28 was the main responsable for macrolide resistance where as that <jats:italic>emm<\/jats:italic> 77T28 clones were it to tetraclycline resistance. A wide variety of macrolide resistance genes were responsible for three macrolide resistance phenotypes.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1471-2180-12-215","type":"journal-article","created":{"date-parts":[[2012,9,21]],"date-time":"2012-09-21T14:14:08Z","timestamp":1348236848000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Molecular epidemiology, antimicrobial susceptibilities and resistance mechanisms of Streptococcus pyogenes isolates resistant to erythromycin and tetracycline in Spain (1994\u20132006)"],"prefix":"10.1186","volume":"12","author":[{"given":"Virginia","family":"Rubio-L\u00f3pez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvia","family":"Valdezate","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"\u00c1lvarez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pilar","family":"Villal\u00f3n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Jos\u00e9","family":"Medina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celia","family":"Salcedo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan-Antonio","family":"S\u00e1ez-Nieto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2012,9,21]]},"reference":[{"key":"1754_CR1","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1128\/CMR.13.3.470-511.2000","volume":"13","author":"MW Cunningham","year":"2000","unstructured":"Cunningham MW: Pathogenesis of group a streptococcal infections. 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