The emergence of lincosamide and macrolide resistance in Streptococcus pyogenes from Pakistan

Background: Many reports from developing and developed countries have shown increased resistance against macrolides and other antibiotics among Streptococcus pyogenes or group A streptococci (GAS). Objectives: To study the current resistance pattern of S. pyogenes in Pakistan to commonly prescribed antibiotics. Materials and Methods: Altogether, 85 (53%) of S. pyogenes strains were isolated and collected from 160 various clinical specimens from patients in Pakistan. Results: Among other strains, 51 (32%) group D streptococci, 15 (9%) group B streptococci, 7 (4%) group G streptococci, and 2 (1%) group C streptococci were also identified. Predominantly, S. pyogenes were isolated from throat swabs (55%), followed by pus (17%), tissues (12%), and blood or wound swabs (7%). The majority of the S. pyogenes isolates were collected during the rainy season (55%) followed by cool season (40%), while merely 5% strains were isolated during the hot season, indicating a correlation of GAS incidence with seasonal changes. The highest rate of resistance was observed against clindamycin (29%), followed by macrolides (20%), and ciprofloxacin (14%). However, all strains of GAS were sensitive to penicillin and co-amoxiclav. Conclusions: The emergence of lincosamide and macrolide resistance among GAS is a major problem worldwide which is probably due to misuse of antibiotics, self-medication, or frequent use of these antibiotics.