Emergence of Erythromycin- and Clindamycin-Resistant Streptococcus pyogenes emm90 Strains in Hawaii

ABSTRACTWe identified 12 erythromycin- and clindamycin-resistant emm90 group A streptococcus (GAS) isolates during a retrospective invasive disease survey in Hawaii. A comparison with 20 type-matched isolates showed all resistant isolates to be emm90.4b with the constitutive or inducible macrolide-lincosamide-streptogramin B resistance phenotype (cMLSBor iMLSB). All isolates had the same pulsed-field gel electrophoresis (PFGE) pattern, suggesting clonal spread.