Latest medical literature on erythromycin

Our library of drug research abstracts drawn from the medical literature is updated on a regular schedule, and you can be assured that new erythromycin research articles will be listed here shortly after becoming available to us.

Medical research on erythromycin

Erythromycin resistance caused by erm(A) subclass erm(TR) in a Danish invasive pneumococcal isolate: Are erm(A) pneumococcal isolates overlooked?

Scand J Infect Dis. 2008; 40(6): 584-7
Lambertsen L, Ekelund K, Hansen DS, Kaltoft M, Christensen JJ, Hammerum AM
Erm(A) is rarely reported as erythromycin resistance determinant in pneumococci. One invasive erm(A) isolate was initially tested intermediate erythromycin resistant using E-test. However, upon re-testing it was resistant, thus close to the breakpoint value. This may be a reason why erm(A) only rarely is reported to cause resistance in pneumococci.

[Antimicrobial susceptibility and resistance patterns of Staphylococcus aureus isolated from patients and carriers in Valdivia city, Chile.]

Rev Chilena Infectol. 2008 Jun; 25(3): 175-8
Otth R L, Wilson Sch M, Bustamante H N, Fernández J H, Otth L C
In vitro susceptibility of nosocomial and community acquired strains of Staphylococcus aureus must be periodically evaluated because of its continuous evolution. Aim: To know the antimicrobial susceptibility of S. aureus isolated in Valdivia, to determine the prevalence of methicillin resistance and global patterns of resistance and to compare the evolution of the susceptibility along the years. Material and Methods: A total of 278 S. aureus strains were evaluated: 136 obtained from hospitalized patients, 50 belonged to outpatients and 92 to healthy carriers. Antimicrobial agents tested were: penicillin, oxacillin, vancomycin, gentamycin, ciprofloxacin, lincomycin and erythromycin. Results: Thirty three, 28 and 1.1% of strains isolated from hospitalized, outpatients and carriers, respectively, were methicillin-resistant. Six resistance patterns were found. No vancomycin resistant strain was isolated. Comment: It is worrisome that 2% of S. aureus strains obtained from hospitalized patients showed intermediate resistance to vancomycin.

Molecular characteristics of serotype 3 Streptococcus pneumoniae isolates among community-acquired pneumonia patients in Japan.

J Infect Chemother. 2008 Jun; 14(3): 258-261
Isozumi R, Ito Y, Ishida T, Hirai T, Ito I, Maniwa K, Hayashi M, Kagioka H, Hirabayashi M, Onaru K, Tomioka H, Tomii K, Gohma I, Osawa M, Imai S, Takakura S, Iinuma Y, Chin K, Ichiyama S, Mishima M,
In order to understand the spread of the erythromycin-resistant serotype 3 Streptococcus pneumoniae clone in Japan, we have assessed the molecular characteristics of this clone. Among 156 S. pneumoniae isolates recovered from adults with community-acquired pneumonia between 2003 and 2005, 42 were serotype 3 and 40 were sequence type (ST) 180/Netherlands(3)-31 by multilocus sequence typing. Thirty-eight of the 40 ST 180 isolates had acquired resistance to erythromycin via the ermB gene. Although the ermB-positive ST180 clone isolates were more susceptible to penicillin and trimethoprim-sulfamethoxazole than ermB-positive non-ST180 isolates and contained a less mutated pbp1a or pbp2b gene, without a mefA gene, the ST180 clone was highly prevalent among ermB-positive isolates. Routine surveillance for the ST180 S. pneumoniae clone may soon become necessary.

Multiple aphthoid syphilitic chancres of the oral cavity.

Int J STD AIDS. 2008 Jul; 19(7): 486-7
Veraldi S, Lunardon L, Persico MC, Francia C, Bottini S
We describe the case of a 31-year-old man who was affected by three asymptomatic, aphthoid, syphilitic chancres of the oral cavity. These lesions were accompanied by right latero-cervical and chin lymphadenopathy. The infection was previously diagnosed as aphthous stomatitis. The search for Treponema pallidum by means of darkfield microscope examination was positive. The patient was successfully treated with oral erythromycin ethylsuccinate. To our knowledge, this is the first case of multiple aphthoid syphilitic chancres of the oral cavity reported in the literature. We suggest that all patients with a recent history of painless ulcers in the oral cavity, accompanied by regional lymphadenopathy in which the clinical diagnosis has not been confirmed, should undergo a darkfield microscope examination.

UK National Audit of Chlamydial Infection Management in Sexual Health Clinics. Case notes audit: demography, diagnosis and treatment.

Int J STD AIDS. 2008 Jul; 19(7): 469-472
McClean H, Carne C, Bunting P, Bhaduri S, Fernandes A, Dhar J, Estreich S, Daniels D,
The case notes of cases of genital chlamydial infection were audited against the UK National Guideline. This was the first web-based and the largest national audit to date, with 193 clinics in all UK Regions contributing data. About half of all cases had no symptoms, with about one-third attending for routine or asymptomatic screens; suggesting significant provision of screening by clinics that might be managed differently to reduce workload. Nucleic acid amplification tests (NAATs) are now well established for chlamydial detection in UK clinics, with 93% of cases having genital NAATs. Azithromycin is now more commonly used than doxycycline (54% vs. 37%). Of 26 pregnant women, 20 were treated with azithromycin, suggesting that most prescribers treating pregnant women consider that erythromycin is not an adequate alternative to azithromycin. Most women had NAATs obtained from sites recommended by the Guideline, with 93% of women who had genital NAATs having these from the cervix or vulvovaginal area.

Imported tropical infectious ulcers in travelers.

Am J Clin Dermatol. 2008; 9(4): 219-32
Zeegelaar JE, Faber WR
Skin ulcers are a commonly encountered problem at departments of tropical dermatology in the Western world. Furthermore, the general dermatologist is likely to be consulted more often for imported chronic skin ulcers because of the ever-increasing travel to and from tropical countries. The most common cause of chronic ulceration throughout the world is probably pyoderma. However, in some parts of the world, cutaneous leishmaniasis is one of the most prevalent causes. Mycobacterium ulcerans is an important cause of chronic ulcers in West Africa.Bacterial infections include pyoderma, mycobacterial infections, diphtheria, and anthrax. Pyoderma is caused by Staphylococcus aureus and/or beta-hemolytic streptococci group A. This condition is a common cause of ulcerative skin lesions in tropical countries and is often encountered as a secondary infection in travelers. The diagnosis is often made on clinical grounds. Antibacterial treatment for pyoderma should preferably be based on culture outcome. Floxacillin is generally active against S. aureus and beta-hemolytic streptococci. Infection with Mycobacterium ulcerans, M. marinum, and M. tuberculosis may cause ulcers. Buruli ulcers, which are caused by M. ulcerans, are endemic in foci in West Africa and have been reported as an imported disease in the Western world. Treatment is generally surgical, although a combination of rifampin (rifampicin) and streptomycin may be effective in the early stage. M. marinum causes occasional ulcerating lesions in humans. Treatment regimens consist of combinations containing clarithromycin, rifampin, or ethambutol. Cutaneous tuberculosis is rare in travelers but may be encountered in immigrants from developing countries. Treatment is with multiple drug regimens consisting of isoniazid, ethambutol, pyrazinamide, and rifampin. Cutaneous diphtheria is still endemic in many tropical countries. Cutaneous diphtheria ulcers are nonspecific and erythromycin and penicillin are both effective antibacterials. Antitoxin should be administered intramuscularly in suspected cases. Anthrax is caused by spore-forming Bacillus anthracis. This infection is still endemic in many tropical countries. Eschar formation, which sloughs and leaves behind a shallow ulcer at the site of inoculation, characterizes cutaneous anthrax. Penicillin and doxycycline are effective antibacterials.Cutaneous leishmaniasis is caused by different species belonging to the genus Leishmania. The disorder is one of the ten most frequent causes of skin diseases in travelers returning from (sub)tropical countries. The clinical picture is diverse, ranging from a painless papule or nodule to an ulcer with or without a scab. Treatment depends on the clinical manifestations and the species involved.Sporotrichosis, chromo(blasto)mycosis, and mycetoma are the most common mycoses that may be accompanied by ulceration. Infections are restricted to certain regions and often result from direct penetration of the fungus into the skin. Anti-mycotic treatment depends on the microorganism involved.The most common causes of infectious skin ulceration encountered in patients from tropical countries who present at a department of tropical dermatology are reviewed in this article.

Presence of steroid hormones and antibiotics in surface water of agricultural, suburban and mixed-use areas.

Environ Monit Assess. 2008 Jun 21;
Velicu M, Suri R
The occurrence of pharmaceutically active chemicals (PACs) in the natural aquatic environment is recognized as an emerging issue due to the potential adverse effects these compounds pose to aquatic life and humans. This study presents the monitoring of two major categories of PACs in surface water: steroid hormones and antibiotics. Surface water samples were collected in the fall season from 21 locations in suburban (4), agricultural (5) and mixed (12) use suburban and agricultural areas. The water samples collected were analyzed using GC/MS for aqueous concentration of eleven steroid hormones: six natural (17alpha-estradiol, 17beta-estradiol, estrone, estriol, 17alpha-dihydroequilin, progesterone) and five synthetic (gestodene, norgestrel, levonorgestrel, medrogestone, trimegestone). In addition, 12 antibiotics (oxytetracycline, chlorotetracycline, tetracycline, sulfamethoxazole, sulfamethazine, trimethoprim, lincomycin, norfloxacin, ofloxacin, roxithromycin, erythromycin, tylosin tartrate) were analyzed using LC/MS. Steroid hormones detected in surface water were: 17alpha-estradiol, 17beta-estradiol, 17alpha-dihydroequilin, estriol, estrone, progesterone and trimegestone. Estrone had the highest detection frequency of >90% with concentrations ranging from 0.6 to 2.6 ng/l. The second most frequently detected estrogen was estriol (>80%) with concentrations ranging from 0.8 to 19 ng/l. The detection frequency varied at different sampling locations. No antibiotics were detected in the 21 streams sampled. This study aims to give a better understanding on the presence, fate and transport of PACs derived from humans and animals.

Molecular characterization of Streptococcus mutans strains isolated from the heart valve of an infective endocarditis patient.

J Med Microbiol. 2008 Jul; 57(Pt 7): 891-5
Nemoto H, Nakano K, Nomura R, Ooshima T
Streptococcus mutans, known to be an aetiological agent of dental caries, is occasionally isolated from patients with infective endocarditis (IE). S. mutans strains with a defect in all three types of glucosyltransferase (GTF) obtained from an infected heart valve extirpated from an IE patient have been reported previously. In this study, molecular analyses of strains detected in heart valve (strain V1) and dental plaque (strain P1) samples taken from the same patient were performed. Complete nucleotide alignments of the gtfB, gtfC and gtfD regions in strains V1 and P1, as well as in the reference strain MT8148, were determined, which revealed the existence of alignments with a high similarity to erythromycin- and spectinomycin-resistance genes in the middle of the gtfB-gtfC and gtfD genes, respectively, of V1. Strain V1 also showed a higher MIC for these two antibiotics compared with strain P1. Next, primers to detect the specific sequences of the antibiotic-resistance genes in strain V1 were constructed and PCR amplification was performed with template DNA from dental plaque and infected valve tissue samples taken from the patient. Attenuated expression of GTFs in V1 caused a significantly lower susceptibility to phagocytosis by human polymorphonuclear leukocytes compared with the reference strain. These results suggest that the blood isolate V1 found in the oral cavity invaded and survived in the bloodstream for a long duration and that this was related to its virulence in IE in our patient.

Effect of putative efflux pump inhibitors and inducers on the antimicrobial susceptibility of Campylobacter jejuni and Campylobacter coli.

J Med Microbiol. 2008 Jul; 57(Pt 7): 851-5
Hannula M, Hänninen ML
The CmeABC efflux pump plays an important role in the antimicrobial resistance of Campylobacter jejuni and Campylobacter coli. The aim of this investigation was to study the effect of putative efflux pump inhibitors, phenyl-arginine-beta-naphthylamide (PAbetaN) and 1-(1-naphthylmethyl)-piperazine (NMP), as well as the effect of putative efflux pump inducers, sodium salicylate and sodium deoxycholate, on the MIC levels of erythromycin, ciprofloxacin, kanamycin, tetracycline and rifampicin for C. jejuni and C. coli. Our results indicated that susceptibility to erythromycin and rifampicin increased, respectively, 8- to 32- and 8- to 64-fold in the presence of PAbetaN and to a lesser extent in the presence of NMP. Salicylate produced a 2- to 4-fold increase in ciprofloxacin MIC values, whereas little effect was observed in the presence of deoxycholate.

Antimicrobial susceptibility of Streptococcus pneumoniae isolated from patients with respiratory tract infections in Thailand.

Southeast Asian J Trop Med Public Health. 2008 May; 39(3): 461-6
Srifuengfung S, Tribuddharat C, Champreeda P, Daniels J, Chokephaibulkit K, Wongwan N, Polwichai P
A total of 400 clinical Streptococcus pneumoniae strains from patients with respiratory diseases were collected from January 2002 to December 2005. In this study, an increased prevalence of penicillin-nonsusceptible S. pneumoniae (PNSP) from 63% in 2002-2003 to 69% in 2004-2005 was found. During 2004-2005, 56% were erythromycin-nonsusceptible S. pneumoniae (ENSP) and 54% were both PNSP and ENSP. The PNSP, ENSP and PNSP+ENSP groups showed similar trends, ie, sensitive to amoxicillin/clavulanate (range 97.2-98.5%), levofloxacin (range 90.7-92.4%), ceftriaxone (range 87.1-89.4%), and ofloxacin (range 64.8-66.1%). Lower levels of susceptibility were detected for azithromycin, clarithromycin, cefdinir, cefprozil, clindamycin, co-trimoxazole, chloramphenicol and tetracycline in penicillin and erythromycin-nonsusceptible strains. Of the macrolide-resistant S. pneumoniae, 55% of strains exhibited the M phenotype and 45% the constitutive MLS(B) phenotype. No pneumococci with the inducible MLS(B) phenotype were detected in Thailand.