Molecular characterization and evaluation of the emerging antibiotic-resistant Streptococcus pyogenes from eastern India

Abstract

BackgroundGroup A Streptococcus strains causing wide variety of diseases, recently became noticeable in eastern India, are not amenable to standard treatment protocol thus enhancing the possibility of disease morbidity by becoming antibiotic resistance.MethodsThe association of Lancefield group A Streptococcal variation with degree of vir architectural diversity was evaluated using emm typing and restriction fragment length polymorphism analyses. The antibiotic sensitivity patterns were examined by modified Kirby-Bauer method of disk diffusion. Percentage calculations, 95% confidence interval and one-way ANOVA were used to assess differences in proportions.ResultsOur observations revealed 20 different emm types and 13 different HaeIII vir typing patterns. A 1.2 kb fragment was found in all HaeIII typing pattern. Fragments of 1.2 kb and 550 bp were conserved in majority of the isolates. HinfI digestion was found proficient in differentiating the strains of same vir typing patterns. Strong predominance of speC (85%) and speF (80%) genes have been observed encoding exotoxins production. 4 isolates were found to be erythromycin resistant and were of genotype emm49. High degree of tetracycline resistance was shown by 53.57% isolates which belonged to 12 different emm genotypes.ConclusionsThese findings suggested that in addition to emm typing, sequential application of HaeIII and HinfI restriction enzymes in vir typing analysis is an effective tool for group A streptococcal molecular characterization associated with antibiotic resistance.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-2079-9) contains supplementary material, which is available to authorized users.

Group A Streptococcus Antibiotic Resistance in Iranian Children: A Meta-analysis

“… 5 In the present meta-analysis, the prevalence of GAS strains resistant to cephalosporins was variable between 8.1% to 18.2%. To compare, the rate of cefotaxime-resistant GAS (8.8%) in Iran was higher than those reported from Germany (0%), Senegal (0%), Pakistan (1%), and India (0%), 23 - 25 , 27 ceftriaxone-resistant GAS (8.1%) was higher than those of Senegal (0%) and Argentina (0%), 24 , 26 and cefixime-resistant GAS (17.6%) was higher than that of Senegal (0%). 24 Additionally, GAS resistance to narrow-spectrum cephalosporins, including cefazolin (10.7%), cephalexin (12.9%), and cephalothin (18.2%) was relatively low.…”

“…In addition to macrolides, lincosamides (clindamycin and lincomycin) along with streptogramins are alternate options for GAS infections therapy in patients with allergy to penicillin or treatment failure. 34 In Iran, 12.4% of GAS strains were resistant to clindamycin, while the low rate of resistance was found for clindamycin in studies from Senegal (0%), India (0%), Spain (0%), Japan (1.4%) and Germany (1.1%) 24 , 27 , 35 - 37 as well as a high rate of resistance reported in studies from Pakistan (29%) and China (96.8%). 25 , 28 Clindamycin can also be used to treat chronic pharyngeal GAS carriers, which occur in 20% of school-aged children during the winter and spring.…”

“… 5 Similar findings were observed in this study, and the tetracycline resistance rate was high in Iran (30.4%), which is similar to other countries such as Senegal, India, China, South Korea, and Poland. 24 , 27 , 28 , 32 , 33 The tet (M) and also rarely tet (O), tet (S), and tet (T) genes are associated with tetracycline resistance in S. pyogenes . 3 Trimethoprim/sulfamethoxazole is also not recommended due to failure to eradicate bacteria from the pharynx.…”

Identification of potential antivirulence agents by substitution-oriented screening for inhibitors of Streptococcus pyogenes sortase A

“…It is of key importance to develop new approaches for the treatment of different life-threatening diseases caused by strains of S. pyogenes, as resistance to currently used antibiotics is a significant problem [3,26]. In this study, we employed a rational approach based on SOS combined with an in vitro fluorometric assay to search for a potent Sp-SrtADN81 inhibitor.…”

Una regla de predicción clínica ¿anticipa el diagnóstico de la faringitis estreptocóccica en niños de 2 a 15 años?

“…De acuerdo con la vigilancia epidemiológica nacional de las infecciones por S. pyogenes publicado por el Instituto de Salud Pública de Chile, la susceptibilidad a la penicilina fue de 100% 23 . Esto está en gran contraste con países como India, donde 23,6% de los aislados de S. pyogenes tienen una susceptibilidad intermedia a penicilina 24 . Finalmente, no existen datos con respecto a las reacciones adversas derivadas del uso innecesario de antimicrobianos.…”