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J Infect Dis. 2006 Dec 15;194(12):1771-3. Epub 2006 Nov 3.

Antibiotic selection may contribute to increases in macrolide-resistant Treponema pallidum.

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  • 1Department of Neurology, University of Washington School of Medicine, Seattle, WA 98104-2499, USA.


To determine whether the 23S rRNA mutation that confers macrolide resistance is present in >1 Treponema pallidum strain, 58 isolates collected between 2001 and 2005 were screened for this mutation and for an unrelated sequence that distinguishes between strains. The odds of identifying a macrolide-resistant strain increased over time (P=.006). In subjects who had received macrolides in the previous year, the relative risk of harboring a resistant strain was 2.2 (95% confidence interval, 1.1-4.4; P=.02). The macrolide-resistant strains were not identical. These findings suggest that macrolide resistance may be increasing in multiple strains in response to antibiotic pressure.

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