Background: Scarce data are available about the antimicrobial resistance of Group A Streptococcus in South America. Methods: This study evaluated the antimicrobial susceptibility profile of 1,112 isolates of Group A Streptococcus during the period from 1993 to 2009 in Curitiba city, Brazil. Macrolide-resistant isolates were characterized by emm typing and pulsed-field gel electrophoresis. Results: All isolates were susceptible to penicillin, vancomycin, and tigecycline. On the contrary, 18.6% of the isolates were resistant to tetracycline, presenting a minimum inhibitory concentration (MIC)50/MIC90 of 32/64 mg/L. Erythromycin resistance rose from 1.9% before 2000 to 4% after 2000 and was associated with a marked increased of MIC levels. Simultaneously, both the phenotype and genotype of macrolide resistance were modified as the M phenotypes (mef(A) genotype) were replaced by the cMLSB phenotypes (erm(B) genotype). Conclusion: This polyclonal spreading of cMLSB macrolide resistance has not been previously observed in South America and should stimulate further epidemiological surveillance in this part of the world.
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