{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T18:58:08Z","timestamp":1788721088242,"version":"build-2803163510"},"reference-count":0,"publisher":"American Society of Tropical Medicine and Hygiene","license":[{"start":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T00:00:00Z","timestamp":1722297600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,30]]},"abstract":"<jats:p>Macrolide antibiotics are recommended for the treatment of pneumococcal pneumonia and invasive pneumococcal disease (IPD). Prior to 2000, \u223c10% of <jats:italic>Streptococcus pneumoniae<\/jats:italic> strains isolated from IPD cases in Latin American countries were resistant to macrolides. The mechanism of resistance to macrolides was associated mainly with the efflux pump known as the macrolide efflux genetic assembly, since most pneumococcal strains carried the <jats:italic>mef(A\/E)<\/jats:italic> gene, whereas &lt;6% strains carried both the methylase gene <jats:italic>ermB<\/jats:italic> and <jats:italic>mef(A\/E)<\/jats:italic>. In the first decade of this century, a significant increase in the prevalence of macrolide resistance was observed in pneumococcal strains in both Mexico and Peru. Approximately 30% of <jats:italic>S. pneumoniae<\/jats:italic> strains in these countries were already resistant to erythromycin, while the prevalence in Colombia, Argentina, and Brazil remained below 10%. During the last decade, we have been experiencing a worrisome increase in pneumococcal strains carrying resistance to macrolides, with a prevalence of up to 80% for resistance to erythromycin. The mechanism for disseminating macrolide resistance has evolved. Currently, more than 55% of invasive <jats:italic>S. pneumoniae<\/jats:italic> macrolide-resistant strains carry both the <jats:italic>ermB<\/jats:italic> and the <jats:italic>mef(A\/E)<\/jats:italic>\/<jats:italic>mel<\/jats:italic> genes. Lessons learned from the current macrolide resistance crisis in Latin America can inform interventions in other regions.<\/jats:p>","DOI":"10.4269\/ajtmh.23-0913","type":"journal-article","created":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T13:58:24Z","timestamp":1722347904000},"source":"Crossref","is-referenced-by-count":6,"title":["The Crisis of Macrolide Resistance in Pneumococci in Latin America"],"prefix":"10.4269","author":[{"given":"Carolina","family":"Viteri-D\u00e1vila","sequence":"first","affiliation":[{"name":"One Health Research Group, Universidad de Las Am\u00e9ricas, Quito, Ecuador;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Morales-Jad\u00e1n","sequence":"additional","affiliation":[{"name":"One Health Research Group, Universidad de Las Am\u00e9ricas, Quito, Ecuador;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aidan","family":"Creel","sequence":"additional","affiliation":[{"name":"Summer Undergraduate Research Experience Program, School of Graduate Studies in the Health Sciences, University of Mississippi Medical Center, Jackson, Mississippi;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana G.","family":"Jop Vidal","sequence":"additional","affiliation":[{"name":"Department of Cell and Molecular Biology, University of Mississippi Medical Center, Jackson, Mississippi;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier M.","family":"Boldo","sequence":"additional","affiliation":[{"name":"Research Center, Health Sciences Academic Division, Juarez Autonomous University of Tabasco, Villahermosa, Mexico;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ismar A.","family":"Rivera-Olivero","sequence":"additional","affiliation":[{"name":"One Health Research Group, Universidad de Las Am\u00e9ricas, Quito, Ecuador;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Consuelo","family":"Bautista-Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Laboratory of Biotechnology, Colegio de Postgraduados Campus Tabasco, Cardenas, Mexico;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babek","family":"Alibayov","sequence":"additional","affiliation":[{"name":"Department of Cell and Molecular Biology, University of Mississippi Medical Center, Jackson, Mississippi;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel \u00c1ngel","family":"Garcia-Bereguiain","sequence":"additional","affiliation":[{"name":"One Health Research Group, Universidad de Las Am\u00e9ricas, Quito, Ecuador;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge E.","family":"Vidal","sequence":"additional","affiliation":[{"name":"Department of Cell and Molecular Biology, University of Mississippi Medical Center, Jackson, Mississippi;"},{"name":"Center for Immunology and Microbial Research, University of Mississippi Medical Center, Jackson, Mississippi"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/aop\/article-10.4269-ajtmh.23-0913\/article-10.4269-ajtmh.23-0913.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/aop\/article-10.4269-ajtmh.23-0913\/article-10.4269-ajtmh.23-0913.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/aop\/article-10.4269-ajtmh.23-0913\/article-10.4269-ajtmh.23-0913.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T13:58:24Z","timestamp":1722347904000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/aop\/article-10.4269-ajtmh.23-0913\/article-10.4269-ajtmh.23-0913.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,30]]},"references-count":0,"URL":"https:\/\/doi.org\/10.4269\/ajtmh.23-0913","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,30]]}}}