Bacteria can resist macrolide antibiotics (such as azithromycin, clarithromycin, and erythromycin) through several mechanisms. mef(A) encodes an efflux pump that removes macrolides from bacterial cells; ere(B) and mph(A) encode enzymes that inactivate macrolides through esterolysis and phosphorylation, respectively. These mechanisms are common in pneumococci, streptococci, and other gram-positive bacteria.
Detection of these genes in molecular susceptibility testing identifies macrolide-resistant infections and guides selection of alternative antibiotics. Sample type is typically a culture isolate or direct clinical specimen.
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