emm Types and clusters and macrolide resistance of pediatric group A streptococcal isolates in Central Greece during 2011-2017

Abstract

Background The surveillance of emm types and macrolide susceptibility of group A streptococcus (GAS) in various areas and time periods enhances the understanding of the epidemiology of GAS infections and may guide treatment strategies and the formulation of type-specific vaccines. Greece has emerged as a country with high macrolide use. However, studies suggest a gradual reduction in macrolide consumption after 2007. Methods During a 7-year period (2011-2017), 604 GAS isolates were recovered from consecutive children presenting with pharyngeal or nonpharyngeal infections in Central Greece; 517 viable isolates underwent molecular analysis, including emm typing. Results Isolates belonged to 20 different emm types (in decreasing order of prevalence: 1, 89, 4, 12, 28, 3, 75 and 6, accounting for 88.2% of total isolates). The emm types comprised 10 emm clusters (five most common clusters: E4, A-C3, E1, A-C4 and A-C5). The emm89 isolates were acapsular ('new clade'). Overall macrolide resistance rate was 15.4%, and cMLS B emerged as the predominant resistance phenotype (56.4%). The lowest annual resistance rates occurred in 2014 (13.1%), 2016 (5.5%) and 2017(8.0%) (P for trend = 0.002). Consumption of macrolide/lincosamide/streptogramin B declined by 22.6% during 2011-2017. Macrolide resistance and emm28 and emm77 types were associated (both P<0.001). The most frequently identified genetic lineages of macrolide-resistant GAS included emm28/ ST52, emm77/ST63, emm12/ST36, emm89/ST101 and emm4/ST39. We estimated that

Prevalence and antibiotics susceptibility profiles of Streptococcus pyogenes among pediatric patients with acute pharyngitis at Felege Hiwot Comprehensive Specialized Hospital, Northwest Ethiopia

“…Streptococcus pyogenes infection among the pediatric group is a cause of acute pharyngitis which could leads morbidity and mortality [ 24 ]. Pediatric patients with acute pharyngitis require microbiologic investigation and proper treatment to abort complications [ 25 ].…”

Prevalence and Antibiotics Susceptibility Profiles of Streptococcus Pyogenes Among Pediatric Patients With Acute Pharyngitis at Felege Hiwot Comprehensive Specialized Hospital, Northwest Ethiopia

“…Streptococcus pyogenes infection among the pediatric group is a cause of acute pharyngitis in pediatric patients which could leads morbidity and mortality [24]. Pediatric patients with acute pharyngitis require microbiologic investiga tion and proper treatment to abort complications [25].…”

Beta-Haemolytic Group A, C and G Streptococcal Infections in Southern Hungary: A 10-Year Population-Based Retrospective Survey (2008–2017) and a Review of the Literature

“… 56 , 57 Currently, emm cluster typing (which groups emm types into 48 different clusters on the basis of their structural properties of the M protein). 58 Similar to the emergence of fluoroquinolone-resistant S. pneumoniae , resistant GAS isolates are also increasingly reported; the main mechanism associated with these isolates are the mutations of gyrA and parC genes. 59 The emergence of resistance in GAS has been associated with the extensive use of relevant antibiotics in the country.…”