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Topic: Macrolide

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Streptococci

	Macrolide- and Telithromycin-Resistant S. pyogenes \| CDC EID
		We found a 13% macrolide resistance in 3,866 Streptococcus pyogenes isolated from tonsillopharyngitis patients; 59% macrolide-resistant isolates were distributed in 5 clones, suggesting the importance of both resistance gene transfer and clonal dissemination in the spread of these organisms.
		On average, we demonstrated a 2-fold (13%) increase in macrolide resistance in Belgium from 1999 to 2003, compared to that observed from 1995 to 1997 (6.5%) (1).
		Macrolide resistance and erythromycin resistance determinants among Belgian Streptococcus pyogenes and Streptococcus pneumoniae isolates.
	www.cdc.gov /ncidod/EID/vol11no06/04-1247.htm (2464 words)

	Macrolide - Wikipedia, the free encyclopedia
		The drug Tacrolimus, which is used as an immunosuppressant, is also a macrolide.
		Macrolides tend to accumulate within leukocytes, and are therefore actually transported into the site of infection.
		A novel,non-antibiotic,anti-inflamatory effect of 14-membered macrolides was discovered in Japan(Kudo S. et al.),which is especialy effective in improving control of diffuse panbronchiolitis(DPB).
	en.wikipedia.org /wiki/Macrolide (357 words)

	Hidden Epidemic of Macrolide-resistant Pneumococci \| CDC EID
		Macrolides are microbiostatic agents that reversibly bind to the 23S ribosomal RNA in the 50S subunit of ribosomes and block protein synthesis (8).
		The slight reduction in macrolide resistance among pneumococcal isolates collected as part of the PROTEKT US study from 2001 to 2002 may be a consequence of the February 2000 introduction of the 7-valent pneumococcal conjugate vaccine (18).
		Macrolide resistance rates for isolates collected during the PROTEKT US study from 2001 to 2002 vary according to region; at a state level, the highest prevalence of pneumococcal macrolide resistance was recorded in Louisiana (48.2%) and the lowest in Vermont (15.2%) (11).
	www.cdc.gov /ncidod/eid/vol11no06/05-0147.htm (3770 words)

	Clinical and Molecular Allergy \| Full text \| Low-dose, long-term macrolide therapy in asthma: An overview
		Macrolides, a class of antimicrobials isolated from Streptomycetes more than 50 years ago, are used extensively to treat sinopulmonary infections in humans.
		To this end, macrolide antibiotics inhibit lymphocyte proliferation in response to phytohemagglutinin, decrease neutrophil accumulation via decrease in chemotactic activity, decrease mucus secretion and decrease contraction of isolated bronchial tissue [16].
		Macrolide antibiotics are efficacious in patients with asthma not treated with corticosteroids by reducing airway hyperreactivity and eosinophilic inflammation.
	www.clinicalmolecularallergy.com /content/2/1/4 (2526 words)

	Emerging Infectious Diseases: Hidden epidemic of macrolide-resistant pneumococci
		However, increased macrolide use has been associated with a global increase in pneumococcal resistance, which is leading to concern over the continued clinical efficacy of the macrolides to treat community-acquired RTIs.
		Irrespective of the identity of the gene responsible for macrolide efflux, mef(A)-positive S. pneumoniae strains displaying this macrolide efflux phenotype (termed the M phenotype) are resistant to 14- and 15-membered ring macrolides (but not lincosamides or streptogramins) and generally display a low level of in vitro resistance to these antimicrobial agents.
		The second major mechanism of macrolide resistance in streptococci, target-site modification, is predominantly encoded by the erm(B) gene, resulting in methylation of an adenine residue on the 23S rRNA by a methylase enzyme.
	www.findarticles.com /p/articles/mi_m0GVK/is_6_11/ai_n13818266 (1030 words)

	Macrolide resistance in Streptococcus pneumoniae: Fallacy or fact?
		Macrolide resistance rates range from 15% to 49% in France, Belgium, Spain, Italy, Uruguay, Greece, Hungary and Korea (35,36), but macrolide resistance is rare (less than 3%) in South Africa and Israel, despite high levels of penicillin resistance (greater than 20%) in those countries (37,38).
		The high degree of tissue penetration and accumulation of the macrolide in the infected tissue contrast with the antimicrobial levels that are achieved in serum, and provide grounds for the argument that the current National Committee for Clinical Laboratory Standards breakpoints for macrolides are not appropriate (49).
		For classic macrolide antibiotics such as erythromycin and clarithromycin, optimal activity is dependent on the time that the drug concentration is above the MIC of the organism, with a goal to exceed the MIC for at least 40% of the dosing interval.
	www.pulsus.com /Infdis/13_01/con1_ed.htm (2170 words)

	Johns Hopkins Division of Infectious Diseases Antibiotic Guide (Site not responding. Last check: 2007-10-08)
		This means that levels of macrolides may easily exceed the level of resistance achievable by the efflux-mediated mechanism of resistance in the pneumococcus.
		This paradox appears to have a rational explanation based upon the mechanism of low level macrolide resistance (concentration-dependent efflux) and the ability of the macrolides to be concentrated upon epithelial surfaces in the respiratory tract at levels exceeding the maximal MIC of the efflux strains of pneumococci.
		While changing the macrolide breakpoints for blood-borne or meningeal isolates of the pneumococcus is unwarranted, the evidence for pneumococcal sinusitis and pneumonia strongly suggests that a higher macrolide breakpoint would be a better predictor of clinical outcome and a more useful tool for managing patients with respiratory tract infections.
	www.hopkins-abxguide.org /show_pages.cfm?content=F5_032401_content.html (1605 words)

	Macrolide Resistance Conferred by Base Substitutions in 23S rRNA -- Vester and Douthwaite 45 (1): 1 -- Antimicrobial ...
		Macrolides are natural polyketide products of secondary metabolism in many actinomycete species (51, 140).
		Two naturally occurring macrolides are shown: erythromycin A, which was the first therapeutic macrolide and possesses a 14-member ring, and tylosin, a 16-member-ring macrolide which has been used extensively in the farming industry both therapeutically and as a growth promoter.
		The circled nucleotides indicate the positions of mutations that confer macrolide drug resistance in bacterial pathogens and laboratory strains (details and references are given in Table 2).
	aac.asm.org /cgi/content/full/45/1/1 (6420 words)

	Macrolide-based transgene control in mammalian cells and mice - Nature Biotechnology (Site not responding. Last check: 2007-10-08)
		In the presence of macrolides, gene expression is induced.
		Macrolides are reputed for their excellent bioavailability, low interference with host metabolism, and optimal pharmacokinetics, all of which are key characteristics for use of E.REX technology in biopharmaceutical manufacturing, tissue engineering, and gene therapy.
		Guay, D.R.P. Macrolide antibiotics in paediatric infection diseases.
	www.nature.com /nbt/journal/v20/n9/full/nbt731.html (4177 words)

	APUA
		Macrolide resistance in streptococci is becoming an important issue all over Europe and we were interested in plotting the first comprehensive map of this problem in Europe and determining both the resistance rates and the prevailing phenotypes.
		with resistance to macrolides was isolated from an immigrant worker (who may have imported the strain) and was picked up since it was an invasive isolate (blood).
		The resistance, whose main surge occurred between 1994 and 1995, is still decidedly on the increase in many areas, and the resistance rates recorded for the individual centres and the overall national resistance rate (roughly 40% in 1997) still place the resistance levels observed in Italy among the highest ever measured world-wide.
	www.tufts.edu /med/apua/Newsletter/16_4a.html (2541 words)

	Emerging Infectious Diseases: Quinolone and Macrolide Resistance in Campyloba... @ HighBeam Research (Site not responding. Last check: 2007-10-08)
		Susceptibility data suggest that erythromycin and other macrolides should remain the drugs of choice in most regions, with systematic surveillance and control measures maintained, but fluoroquinolones may now be of limited use in the empiric treatment of Campylobacter infections in many regions.
		In C. jejuni and C. coli, erythromycin resistance is chromosomally mediated and is due to alteration of the ribosome (12); the resistance mechanism is not consistent with presence of an rRNA methylase, modification of the antibiotic, or efflux (13).
		Thus, while human macrolide and fluoroquinolone use contributes to the increase in resistance in humans, their relative contribution to increase in resistance compared to the use of these agents in husbandry appears to be small.
	www.highbeam.com /library/doc0.asp?DOCID=1G1:72269806&refid=holomed_1 (5058 words)

	ARS \| Publication request: ACQUISITION AND PERSISTENCE OF A TYLOSIN RESISTANCE VEILLONELLA SP. WITHOUT SELECTION ...
		Technical Abstract: High level resistance to macrolide antibiotics, but not lincosamide or streptogramin antibiotics, is characteristic of enzymatic drug inactivation by macrolide phosphotransferase (mph) or esterase (ere) gene families.
		A Veillonella sp (VL2) was found to have acquired high level resistance to tylosin (a macrolide antibiotic), but not lincomycin, in a closed population of chicken ceca bacteria cultured anaerobically in the absence of selection pressure.
		This suggests that a gene, or gene complex, conferring high-level macrolide resistance was acquired from a bacterial species present in the mixed anaerobic population.
	www.ars.usda.gov /research/publications/publications.htm?seq_no_115=161825 (331 words)

	Macrolide Use in Animals - Institute for Food Safety and Security
		Using this guideline, we developed a deterministic model to assess the risk from two macrolide antibiotics, tylosin and tilmicosin.
		The scope of modeling included all label claim uses of both macrolides in poultry, swine, and beef cattle.
		The Guidance Document was followed to define the hazard, which is illness (i) caused by foodborne bacteria with a resistance determinant, (ii) attributed to a specified animal-derived meat commodity, and (iii) treated with a human use drug of the same class.
	www.ifss.iastate.edu /macrolide (360 words)

	Reemergence of Macrolide Resistance in Pharyngeal Isolates of Group A Streptococci in Southwestern Pennsylvania -- ...
		strains that are susceptible to macrolides (5, 31).
		The relationship between trends in macrolide use and resistance to macrolides of common respiratory pathogens.
		Rapid Inversion of the Prevalences of Macrolide Resistance Phenotypes Paralleled by a Diversification of T and emm Types among Streptococcus pyogenes in Portugal.
	aac.asm.org /cgi/content/full/48/2/473 (3080 words)

	Divergent Proarrhythmic Potential of Macrolide Antibiotics Despite Similar QT Prolongation: Fast Phase 3 Repolarization ...
		Macrolide antibiotics are known to have a different proarrhythmic potential in the presence of comparable QT prolongation
		concentration of the macrolide was thereafter increased to the
		The macrolide antibiotics erythromycin, clarithromycin, and azithromycin prolong myocardial repolarization.
	jpet.aspetjournals.org /cgi/content/full/303/1/218 (3473 words)

	Molecular Epidemiology of Macrolide-Resistant Isolates of Streptococcus pneumoniae Collected from Blood and Respiratory ...
		Diversity of ribosomal mutations conferring resistance to macrolides, clindamycin, streptogramin, and telithromycin in Streptococcus pneumoniae.
		Prevalence and characterization of the mechanisms of macrolide, lincosamide, and streptogramin resistance in isolates of Streptococcus pneumoniae.
		Emergence of macrolide and penicillin resistance among invasive pneumococcal isolates in Germany.
	jcm.asm.org /cgi/content/full/43/5/2125 (4302 words)

	Macrolide drug interactions: an update -- Pai et al. 34 (4): 495 -- The Annals of Pharmacotherapy
		OBJECTIVE: To describe the current drug interaction profiles for the commonly used macrolides in the US and Europe, and to comment on the clinical impact of these interactions.
		The development and marketing of newer macrolides are hoped to improve the drug interaction profile associated with this class.
		Some of the newer macrolides demonstrated an interaction profile similar to that of erythromycin; others have improved profiles.
	www.theannals.com /cgi/content/abstract/34/4/495 (611 words)

	Macrolide antibiotics for cystic fibrosis (Cochrane Review)
		There is evidence from the laboratory and from other disease processes that macrolide antibiotics, whilst not directly active against Pseudomonas aeruginosa, may have indirect actions against this organism.
		Objectives: We aimed to test the hypotheses that, in people with CF, macrolide antibiotics:(1) improve clinical status compared to placebo or another antibiotic;(2) do not have unacceptable adverse effects.If benefit was demonstrated, we aimed to assess the optimal type, dose and duration of macrolide therapy.
		Further studies are needed to clarify the precise role of azithromycin in the treatment of CF lung disease.
	www.update-software.com /abstracts/ab002203.htm (496 words)

	Tissue Reparative Effects of Macrolide Antibiotics in Chronic Inflammatory Sinopulmonary Diseases -- Garey et al. 123 ...
		Van Bambeke, F, Montenez, JP, Piret, J, et al Interaction of the macrolide azithromycin with phospholipids: I. Inhibition of lysosomal phospholipase A1 activity.
		Suzuki, H, Shimomura, A, Ikeda, K, et al Effects of long-term low-dose macrolide administration on neutrophil recruitment and IL-8 in the nasal discharge of chronic sinusitis patients.
		Itkin, IH, Menzel, ML The use of macrolide antibiotic substances in the treatment of asthma.
	www.chestjournal.org /cgi/content/full/123/1/261 (2288 words)

	Emerging Infectious Diseases: Macrolide- and telithromycin-resistant Streptococcus pyogenes, Belgium, 1999-2003
		The problem of these infections is growing as resistance increases among S. pyogenes to the macrolide group of antimicrobial drugs commonly used to treat such infections (1-4).
		The newest generation of macrolides, the ketolides, are also active against macrolide-resistant strains; however, few S. pyogenes strains of the cMLS phenotype have been found to be ketolide resistant (6).
		We investigated the temporal trends in resistance and clonality among macrolide (including telithromycin)-resistant S. pyogenes recovered from patients with tonsillopharyngitis during surveillance studies conducted in Belgium.
	www.findarticles.com /p/articles/mi_m0GVK/is_6_11/ai_n13818286 (1404 words)

	News - Macrolide Resistance Doubles In Five Years
		Prevalence of macrolide resistance among pneumococci doubled in the United States between 1995 and 1999.
		"Macrolide resistance is now common in the US among invasive pneumococci," say investigators with the US Active Bacterial Core Surveillance/Emerging Infections Program Network.
		"Macrolide resistance increased to 20.4 percent in 1999 from 10.6 percent in 1995.
	www.docguide.com /news/content.nsf/news/8525697700573E1885256AE800496803 (477 words)

	Macrolide antibiotics for cystic fibrosis
		Macrolide antibiotics have no direct killing effect on Pseudomonas aeruginosa, however they may reduce the activity of these bacteria.
		Further studies are required to define the optimal role of azithromycin or other macrolide antibiotics for chest infection in people with cystic fibrosis.
		Published or unpublished randomised controlled trials of macrolide antibiotics compared to placebo, another class of antibiotic or another macrolide antibiotic.
	www.cochrane.org /reviews/en/ab002203.html (577 words)

	Macrolide antibiotics and cystic fibrosis -- Peckham 57 (3): 189 -- Thorax
		Macrolide antibiotics and cystic fibrosis -- Peckham 57 (3): 189 -- Thorax
		The macrolide antibiotics are an intriguing group of drugs with
		Long-term macrolide antibiotics improve pulmonary function in cystic fibrosis (abstract).
	thorax.bmjjournals.com /cgi/content/full/57/3/189 (1010 words)

	Regulation of Transcription of the mph(A) Gene for Macrolide 2'-Phosphotransferase I in Escherichia coli: ...
		Regulation of Transcription of the mph(A) Gene for Macrolide 2'-Phosphotransferase I in Escherichia coli: Characterization of the Regulatory Gene mphR(A) -- Noguchi et al.
		Cloning and nucleotide sequence of the mphB gene for macrolide 2'-phosphotransferase II in Escherichia coli.
		Expression of the mphB gene for macrolide 2'-phosphotransferase II from Escherichia coli in Staphylococcus aureus.
	jb.asm.org /cgi/content/full/182/18/5052 (3479 words)

	Binding Site of Macrolide Antibiotics on the Ribosome: New Resistance Mutation Identifies a Specific Interaction of ...
		Nucleotide residues whose accessibility to chemical modification is affected by macrolides are marked by dots.
		Positions 2058 and 2059 important for macrolide binding are seen at the bottom of the peptidyl transferase cavity.
		Nucleotides involved in interaction with macrolide antibiotics are shown in color (same as in panel A), and A2451 located in the peptidyl transferase active site is shown in fl.
	jb.asm.org /cgi/content/full/183/23/6898 (5008 words)

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