Clonal Relationships Among Isolates of Erythromycin-Resistant Streptococcus pyogenes of Different Geographical Origin

Kataja, Janne; Huovinen, Pentti; Efstratiou, Androulla; Pérez-Trallero, Emilio; Seppälä, Helena

doi:10.1007/s10096-002-0771-8

Cited by 13 publications

(8 citation statements)

References 30 publications

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“…In contrast, in Finland, iMLS B isolates showing co-resistance have reached rates of 93% [19]. A correlation between the M phenotype and co-resistance has been also reported [23], but this was not detected in the present study.…”

Section: Discussioncontrasting

confidence: 75%

“…It was the most common in the present study, indicating it to still be circulating in Spain. This clone has a wide distribution, and it has recently been identified in Finland, Greece, Italy, England and Sweden [23]. Clone C, previously identified in Spain, the United Kingdom and the United States [23] was not detected among the present isolates, although it might be related to the present clones emm 4T4 Sfi 4 and emm 4T4 Sfi 5.…”

Section: Discussionmentioning

confidence: 69%

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Molecular epidemiology, antimicrobial susceptibilities and resistance mechanisms of Streptococcus pyogenes isolates resistant to erythromycin and tetracycline in Spain (1994–2006)

et al. 2012

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BackgroundGroup A Streptococcus (GAS) causes human diseases ranging in severity from uncomplicated pharyngitis to life-threatening necrotizing fasciitis and shows high rates of macrolide resistance in several countries. Our goal is to identify antimicrobial resistance in Spanish GAS isolates collected between 1994 and 2006 and to determine the molecular epidemiology (emm/T typing and PFGE) and resistance mechanisms of those resistant to erythromycin and tetracycline.ResultsTwo hundred ninety-five out of 898 isolates (32.8%) were erythromycin resistant, with the predominance of emm4T4, emm75T25, and emm28T28, accounting the 67.1% of the 21 emm/T types. Spread of emm4T4, emm75T25 and emm28T28 resistant clones caused high rates of macrolide resistance. The distribution of the phenotypes was M (76.9%), cMLSB (20.3%), iMLSB (2.7%) with the involvement of the erythromycin resistance genes mef(A) (89.5%), msr(D) (81.7%), erm(B) (37.3%) and erm(A) (35.9%).Sixty-one isolates were tetracycline resistant, with the main representation of the emm77T28 among 20 emm/T types. To note, the combination of tet(M) and tet(O) tetracycline resistance genes were similar to tet(M) alone reaching values close to 40%. Resistance to both antibiotics was detected in 19 isolates of 7 emm/T types, being emm11T11 and the cMLSB phenotype the most frequent ones. erm(B) and tet(M) were present in almost all the strains, while erm(A), mef(A), msr(D) and tet(O) appeared in less than half of them.ConclusionsSpanish GAS were highly resistant to macrolides meanwhile showed minor resistance rate to tetracycline. A remarkable correlation between antimicrobial resistance and emm/T type was noticed. Clonal spread of emm4T4, emm75T25 and emm28T28 was the main responsable for macrolide resistance where as that emm77T28 clones were it to tetraclycline resistance. A wide variety of macrolide resistance genes were responsible for three macrolide resistance phenotypes.

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Section: Discussioncontrasting

confidence: 75%

Section: Discussionmentioning

confidence: 69%

Molecular epidemiology, antimicrobial susceptibilities and resistance mechanisms of Streptococcus pyogenes isolates resistant to erythromycin and tetracycline in Spain (1994–2006)

et al. 2012

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“…These human pathogens provide a good case study for mapping relationships between typing schemes, since multiple typing methods have been used in their characterization, including T and M serotyping, antibiotic resistance typing, PFGE, restriction fragment length polymorphism (vir typing), emm sequence typing, and MLST (9,17,21). Although all these methods have proven useful for the characterization of GAS isolates, phenotypic methods have declined in popularity and the mainstream methods are now emm sequence typing, PFGE, and MLST.…”

mentioning

confidence: 99%

Illustration of a Common Framework for Relating Multiple Typing Methods by Application to Macrolide-Resistant Streptococcus pyogenes

Silva-Costa²,

et al. 2006

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The studies that correlate the results obtained by different typing methodologies rely solely on qualitative comparisons of the groups defined by each methodology. We propose a framework of measures for the quantitative assessment of correspondences between different typing methods as a first step to the global mapping of type equivalences. A collection of 325 macrolide-resistant Streptococcus pyogenes isolates associated with pharyngitis cases in Portugal was used to benchmark the proposed measures. All isolates were characterized by macrolide resistance phenotyping, T serotyping, emm sequence typing, and pulsed-field gel electrophoresis (PFGE), using SmaI or Cfr9I and SfiI. A subset of 41 isolates, representing each PFGE cluster, was also characterized by multilocus sequence typing (MLST). The application of Adjusted Rand and Wallace indices allowed the evaluation of the strength and the directionality of the correspondences between the various typing methods and showed that if PFGE or MLST data are available one can confidently predict the emm type (Wallace coefficients of 0.952 for both methods). In contrast, emm typing was a poor predictor of PFGE cluster or MLST sequence type (Wallace coefficients of 0.803 and 0.655, respectively). This was confirmed by the analysis of the larger data set available from http://spyogenes.mlst.net and underscores the necessity of performing PFGE or MLST to unambiguously define clones in S. pyogenes.Typing methods are major tools for the epidemiological characterization of bacterial pathogens, allowing the determination of the clonal relationships between isolates based on their genotypic or phenotypic characteristics. Recent technological advances have resulted in a shift from classical phenotypic typing methods, such as serotyping, biotyping, and antibiotic resistance typing, to molecular methods such as restriction fragment length polymorphism (8), pulsed-field gel electrophoresis (PFGE) (25), and PCR serotyping (4). With the availability of affordable sequencing methods, another shift occurred towards sequence-based typing methods such as multilocus sequence typing (MLST) (18) and emm sequence typing (2). Sequence-based methods have a wide appeal since they provide unambiguous data and are intrinsically portable, allowing the creation of databases that, if publicly available through the internet, enable the comparison of local data with those of previous studies in different geographical locations. Ideally, an analysis of each typing method, in terms of discriminatory power, reproducibility, typeability, feasibility, and other characteristics as suggested by Struelens (31), should be performed to better determine which method is appropriate in a given setting.Several molecular epidemiology studies of clinically relevant microorganisms provide a characterization of isolates based on different typing methods (6,8,20,23). Frequently these studies focus on a comparison between the assigned types of different typing methods, from a qualitative point of view, i.e., indicating c...

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“…In contrast, less information is available on the characteristics of TET resistance mechanisms [5,[17][18][19][20][21][22][23] despite the fact that TET resistance has been known for decades [24] and has been recorded in upwards of 50% of isolates [21]. Variation in the prevalence of resistance to these antibiotics has been attributed to clonality of resistant isolates and to particular practices of antibiotic use in different countries [21,[25][26][27].…”

Section: Introductionmentioning

confidence: 99%

Macrolide, lincosamide and tetracycline susceptibility and emm characterisation of invasive Streptococcus pyogenes isolates in Israel

Nir-Paz¹,

Block²,

Shasha³

et al. 2006

International Journal of Antimicrobial Agents

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Clonal Relationships Among Isolates of Erythromycin-Resistant Streptococcus pyogenes of Different Geographical Origin

Cited by 13 publications

References 30 publications

Molecular epidemiology, antimicrobial susceptibilities and resistance mechanisms of Streptococcus pyogenes isolates resistant to erythromycin and tetracycline in Spain (1994–2006)

Molecular epidemiology, antimicrobial susceptibilities and resistance mechanisms of Streptococcus pyogenes isolates resistant to erythromycin and tetracycline in Spain (1994–2006)

Illustration of a Common Framework for Relating Multiple Typing Methods by Application to Macrolide-Resistant Streptococcus pyogenes

Macrolide, lincosamide and tetracycline susceptibility and emm characterisation of invasive Streptococcus pyogenes isolates in Israel

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