Emergence of uncommon emm types of Streptococcus pyogenes among adult patients in southern Taiwan

Chiang-Ni, Chuan; Wu, An‐Bang; Liu, Ching Chuan; Chen, Kow Ton; Lin, Yee Shin; Chuang, Woei Jer; Fang, Hsin Yi; Wu, Jiunn Jong

doi:10.1016/j.jmii.2011.04.005

Cited by 17 publications

(8 citation statements)

References 27 publications

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“…Other than one study which reported that emm106 was one of the prevalent emm types in invasive GAS in New Caledonia (34), this emm type has not been reported in other countries. However, two studies in Taiwan found emm106 to be highly associated with invasive skin and soft tissue infections (28,30). Although we do not have information on the disease manifestations, we did find a strong association of emm106 with abscess/pus isolates.…”

Section: Discussioncontrasting

confidence: 70%

“…Three studies on invasive GAS, one from France, one from 11 European countries, and the other from the United States, also found emm1 to be the leading emm type among invasive GAS isolates (25)(26)(27). Previous studies from Taiwan have also found emm1, emm4, emm12, and emm11 to be among the prevalent emm types, but their proportions varied in different disease entities and populations (28)(29)(30). However, emm28, a leading emm type in Western countries associated with ERY-resistant GAS (5,25,26,31), was detected in only one of the ERY r isolates in the present study.…”

Section: Discussionmentioning

confidence: 93%

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Epidemiology and Molecular Characterization of Macrolide-Resistant Streptococcus pyogenes in Taiwan

et al. 2014

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Recovery from respiratory (throat swab) specimens was an independent factor associated with ERY resistance. emm1 and emm11 GAS isolates were significantly associated with ERY s , while emm22 was detected only in ERY r GAS. In addition, emm106 isolates were prevalent among the abscess/pus isolates, whereas emm12 isolates were strongly associated with a respiratory (throat) origin. In addition to identifying factors associated with ERY resistance in GAS, our study provides helpful information on the changing GAS epidemiology in Taiwan.

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Section: Discussioncontrasting

confidence: 70%

Section: Discussionmentioning

confidence: 93%

Epidemiology and Molecular Characterization of Macrolide-Resistant Streptococcus pyogenes in Taiwan

et al. 2014

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“…This type is highly prevalent in some parts of the world. 1 However, emm-type 89 was absent from a sample collected in India 8 and in a survey during 1997e2008 in Taiwan, 9 illustrating that the predominant emm types vary with geographical location. In mainland China, the most prevalent emm genotype identified from clinical specimen in recent years were emm 1.0, emm 12.0, emm 4.0, and emm 22.0.…”

Section: Discussionmentioning

confidence: 99%

A report on the first outbreak of a single clone group A Streptococcus (emm-type 89) tonsillopharyngitis in China

Liu¹,

Zhao²,

Li³

et al. 2014

Journal of Microbiology, Immunology and Infection

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In 2012, 28 out of 140 staff working for a film crew in a Beijing movie and television base experienced a sudden onset of fever, sore throat, and/or tiredness, headache within the 24 hour period of July 26-27. All of the patients visited the hospital and were diagnosed as having tonsillopharyngitis. On July 28, 2012, a team of Centers for Disease Control and Prevention staff arrived and initiated an outbreak investigation. Pharyngeal swabs were obtained from patients for microbiologic analysis. All isolates of the outbreak were analyzed for toxin-genes and drug-resistance genes by polymerase chain reaction, and were performed for the emm typing and pulsed-field gel electrophoresis typing. On July 30, 2012, Group A Streptococcus was isolated from eight of the 16 throat swab specimens obtained on site. These isolates were found to have the same genotype emm 89. This is the first report to identify Group A Streptococcus emm type-89 as a cause of tonsillopharyngitis in Beijing, China.

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“…Six hundred seventy-seven GAS isolates collected from 1994 to 2008 at National Cheng Kung University Hospital, Tainan, Taiwan, were included in this study. Among these isolates, 334 GAS isolates were collected consecutively from patients older than 20 years between 1997 and 2008 and were described in the previous study (29). An additional 276 isolates were collected from patients younger than 20 years from 1997 to 2008, and 67 isolates were collected from patients of all ages from 1994 to 1996 in this study.…”

Section: Methodsmentioning

confidence: 99%

Epidemiology Analysis of Streptococcus pyogenes in a Hospital in Southern Taiwan by Use of the Updated emm Cluster Typing System

et al. 2016

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g emm typing is the most widely used molecular typing method for the human pathogen Streptococcus pyogenes (group A streptococcus [GAS]). emm typing is based on a small variable region of the emm gene; however, the emm cluster typing system defines GAS types according to the nearly complete sequence of the emm gene. Therefore, emm cluster typing is considered to provide more information regarding the functional and structural properties of M proteins in different emm types of GAS. In the present study, 677 isolates collected between 1994 and 2008 in a hospital in southern Taiwan were analyzed by the emm cluster typing system. emm clusters A-C4, E1, E6, and A-C3 were the most prevalent emm cluster types and accounted for 67.4% of total isolates. emm clusters A-C4 and E1 were associated with noninvasive diseases, whereas E6 was significantly associated with both invasive and noninvasive manifestations. In addition, emm clusters D4, E2, and E3 were significantly associated with invasive manifestations. Furthermore, we found that the functional properties of M protein, including low fibrinogen-binding and high IgG-binding activities, were correlated significantly with invasive manifestations. In summary, the present study provides updated epidemiological information on GAS emm cluster types in southern Taiwan. S treptococcus pyogenes (group A streptococcus [GAS]) is an important Gram-positive human pathogen, which is responsible for more than 500,000 deaths per year (1). Although there is no vaccine available, several vaccine candidates, especially M proteinbased vaccines, are currently in development (2-5). M protein is a bacterial surface protein and has important roles in GAS pathogenesis (6, 7). These include binding to human fibrinogen, complement regulatory proteins, and immunoglobulins; contributing to resistance to phagocytic cell clearance; and inducing vascular leakage during infection (8-15). M protein-based vaccines are constructed from the hypervariable N-terminal region (26-and 30-valent vaccine) or the conserved C-terminal proportion (J8 vaccine and StreptInCor) of the M protein and were all proven to be effective against GAS infection in animal models (2, 3, 5). In addition, phase I trials with the 30-valent and J8 vaccines are under way in North America and Australia, respectively (16).The variable nucleotide sequence encoding the N-terminal region of the M protein is not only the antigenic target for developing GAS vaccines (17-19) but also the basis for the sequence-based emm typing method (20). emm typing is the most widely used molecular typing approach, and more than 200 different emm types have been reported worldwide (21-23). However, since emm typing is based on a small portion of the emm gene, this typing method provides limited information about the predicted conformational structure or functional domains of the M protein (24). emm pattern typing is another typing method that is based on the presence and arrangement of emm and emm-like genes in the GAS genome (25). emm pattern typing has...

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Emergence of uncommon emm types of Streptococcus pyogenes among adult patients in southern Taiwan

Abstract: These results suggest new emm types (emm11, emm81, and emm102) of S pyogenes were introduced into the adult population in southern Taiwan after 2004. The rarely reported emm types, including emm13, emm81, and emm106, caused invasive diseases more often in adult patients.

Cited by 17 publications

References 27 publications

Epidemiology and Molecular Characterization of Macrolide-Resistant Streptococcus pyogenes in Taiwan

Epidemiology and Molecular Characterization of Macrolide-Resistant Streptococcus pyogenes in Taiwan

A report on the first outbreak of a single clone group A Streptococcus (emm-type 89) tonsillopharyngitis in China

Epidemiology Analysis of Streptococcus pyogenes in a Hospital in Southern Taiwan by Use of the Updated emm Cluster Typing System

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