Group A Streptococcal Pharyngitis Serotype Surveillance in North America, 2000–2002

Abstract

Geographic and interseasonal heterogeneity of pharyngeal group A streptococcal (GAS) genotypes (emm types) is poorly characterized. We evaluated emm type and subtype distribution among pediatric pharyngitis isolates obtained from 9 sites in the United States during 2000-2001 (year 1) and from 10 sites in the United States and 1 site in Canada during 2001-2002 (year 2). The 7 predominant types were the same in both years, although their order changed. emm 12, 1, and 28 accounted for 49.2% of year 1 isolates, and emm 1, 12, and 4 accounted for 47.1% of year 2 isolates; 6 types accounted for 72.1% in year 1 and 69.4% in year 2. From year 1 to year 2, the proportions of emm 12 and 28 decreased and emm 1 and 6 increased. Striking intersite and interseasonal variations in the distribution of predominant emm types were observed. We conclude that the most-predominant GAS genotypes were similar for each year despite fluctuations, that intersite and intrasite variations in the distribution of emm types were apparent, and that emm type surveillance is needed as M protein vaccine development proceeds.

Reemergence of emm 1 and a Changed Superantigen Profile for Group A Streptococci Causing Invasive Infections: Results from a Nationwide Study

“…This has made epidemiological surveillance more detailed and revealed potential clusters (emm types) in specific clinical manifestations (17). In addition, emm subtypes have been introduced in recent surveillance papers (29,38). However, a universal high prevalence of certain emm types in invasive GAS diseases may also reflect widespread transmission rather than an increased virulence and invasiveness.…”

Identity and Prevalence of Multilocus Sequence Typing-Defined Clones of Group A Streptococci within a Hospital Setting

“…A 26-valent M protein vaccine under development includes N-terminal peptides covering 39.7% of isolates in this study (Table 1), although it may provide protection against additional M types (22). The serotypes in this expanded-multivalent vaccine were selected, in part, for their frequency in uncomplicated pharyngitis (22) and include serotypes for 86% of North American pharyngeal isolates (37). When only the isolates recovered from throat swabs in this study (n ϭ 47) are considered, the 26-valent vaccine contains epitopes for 26 (55.3%) of the throat GAS.…”

Distribution of emm Genotypes and Antibiotic Susceptibility of Streptococcus pyogenes Strains: Analogy with the Vaccine in Development

“…Örne-ğin Avustralya'da 7 bakteriyemilerden izole edilen 132 AGS suşunda en sık emm1, emm92, emm89, emm8, emm12 tipleri saptanırken, Hindistan'da 8 klinik örneklerden izole edilen S.pyogenes suşlarında en sık emm12, emm92, emm81 ve emm70; Meksika'da 9 ise farenjitli çocuklardan izole edilen S.pyogenes suşlarında en sık emm1, emm12, emm3 ve emm4 tipleri saptanmıştır. Shulman ve arkadaşları 10 , Kuzey Amerika'da benzer bir çalışma grubunu kapsayan iki yıllık araştırmada, birinci yıl en sık izole edilen tipleri emm12 (%20.6), emm1 (%15.5), emm28 (%13.1) ve emm4 (%8.3); ikinci yıl ise emm1 (%22.3), emm12 (%16.3), emm4 (%8.4) ve emm28 (%8.1) olarak belirlemişlerdir. Bu araştırıcılar, ardışık iki yıl süresince izole edilen suşların aynı emm tiplerine sahip olduklarını, ancak izole edilme sıklıklarında değişme olduğunu ifade etmişlerdir 10 .…”

“…Shulman ve arkadaşları 10 , Kuzey Amerika'da benzer bir çalışma grubunu kapsayan iki yıllık araştırmada, birinci yıl en sık izole edilen tipleri emm12 (%20.6), emm1 (%15.5), emm28 (%13.1) ve emm4 (%8.3); ikinci yıl ise emm1 (%22.3), emm12 (%16.3), emm4 (%8.4) ve emm28 (%8.1) olarak belirlemişlerdir. Bu araştırıcılar, ardışık iki yıl süresince izole edilen suşların aynı emm tiplerine sahip olduklarını, ancak izole edilme sıklıklarında değişme olduğunu ifade etmişlerdir 10 . Ülkemizde Dündar ve arkadaşlarının 11 yaptığı çalışmada, 127 S.pyogenes suşunda en sık emm4, emm1, emm2, emm114 ve emm89 tipleri bildirilmiştir.…”