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Background   Streptococcus suis  is an emerging zoonotic pathogen and is the leading cause of bacterial meningitis in adults in Vietnam. Systematic data on the antimicrobial susceptibility profiles of  S. suis  strains isolated from human cases are lacking. We studied antimicrobial resistance and associated resistance determinants in  S. suis  isolated from patients with meningitis in southern Vietnam.    Methods   S. suis  strains isolated between 1997 and 2008 were investigated for their susceptibility to six antimicrobial agents. Strains were screened for the presence and expression of tetracycline and erythromycin resistance determinants and the association of  tet (M) genes with  Tn 916- like transposons. The localization of tetracycline resistance gene  tet (L) was determined by pulse field gel electrophoresis and Southern blotting.    Results  We observed a significant increase in resistance to tetracycline and chloramphenicol, which was concurrent with an increase in multi-drug resistance. In tetracycline resistance strains, we identified  tet (M),  tet (O),  tet (W) and  tet (L) and confirmed their expression. All  tet (M) genes were associated with a  Tn 916-like transposon. The co-expression of  tet (L) and other tetracycline resistance gene(s) encoding for ribosomal protection protein(s) was only detected in strains with a minimum inhibitory concentration (MIC) of tetracycline of ≥ 64 mg/L    Conclusions  We demonstrated that multi-drug resistance in  S. suis  causing disease in humans in southern Vietnam has increased over the 11-year period studied. We report the presence and expression of  tet (L) in  S. suis  strains and our data suggest that co-expression of multiple genes encoding distinct mechanism is required for an MIC ≥ 64 mg/L to tetracycline.

The antimicrobial resistance patterns and associated determinants in Streptococcus suisisolated from humans in southern Vietnam, 1997-2008