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Trends of the Incidence of Erythromycin-Resistant Group A Streptococci in Korea from 1998 through 2002
Hoekyoung Koo, M.D., Sungchul Baek, M.D., Sanghyuk Ma, M.D.*, Heejoo Lee, M.D. and Sungho Cha, M.D.
Department of Pediatrics, Myongji Hospital, College of Medicine, Kwandong University, Goyang Department of Pediatrics*, Changwon Fatima Hospital, Changwon Department of Laboratory Medicine and Pediatrics, College of Medicine, Kyunghee University, Seo
Vol.36 Num.2 (p75~82)
Background:Although the incidence of resistance to macrolides in group A streptococci (GAS) was low in the past, high incidences have now been reported from several countries. We tried to find out trends of the incidence of erythromycin-resistant GAS in Korea before and after adopting the separation of the dispensary from medical practice in the middle of the year 2000.
Methods:Five hundred thirty two isolates from children with suspected pharyngotonsillitis from 1998 through 2002 were serotyped by T-agglutination. Minimal inhibitory concentrations of 330 out of 532 isolates were determined by agar dilution methods.
Results:The prevalent T-serotypes were T12 (36.1%), T4 (12.8%), T1 (10.9%), T2/28 (8.8%), and nontypable (7.1%). Resistance rates to erythromycin (EM) by year were 46.2% in 1998, 18.4% in 1999, 15.4% in 2000, 27.6% in 2001, 36.5% in 2002. T12 in 1999 and 2000 were 36.4% and 25.9%, respectively, which seem to be lower than any other year. This relative low percentage of T12 is associated with increasing percentage of T1 in the same year. The frequency of T12, T1,and T4 were high in each group of isolates of Seoul and Masan. From this viewpoint, there was a similarity between the distribution of T-serotypes of both groups of Seoul and Masan.
Conclusion:The frequency of serotype T12 and T4 of GAS were relatively high in Korea from 1998 through 2002. The low rate of EM resistance in 1999 and 2000 seemed to be caused by a sudden increase of T1. The increasing rate of EM resistance from 2000 to 2002 seemed to be caused by the increase in consumption of new macrolides and the increase of T12.
Keywords : Erythromycin, Resistance, Group A streptococcus, T-serotype