Molecular epidemiology and antimicrobial resistance of group a streptococcus recovered from patients in Beijing, China

Abstract

Background: Group A streptococcus (GAS) is an important human pathogen responsible for a broad range of infections. Epidemiological surveillance has been crucial to detect changes in the geographical and temporal variation of the disease pattern. The objective of this study was to investigate the molecular epidemiological characteristics and antimicrobial resistance of GAS isolates from patients in Children's Hospital in Beijing. Methods: From 2016 to 2017, pharyngeal swab samples were collected from the outpatients in Children's Hospital, Capital Institute of Pediatrics, who were diagnosed with scarlet fever. Antimicrobial susceptibility test was performed according to the distribution of conventional antibiotics and Clinical and Laboratory Standards Institute (CLSI) recommendations. The distribution of the macrolide-resistance genes (ermB, ermA, mefA), emm (M proteincoding gene) typing, and superantigens (SAg) gene profiling were examined by polymerase chain reaction (PCR). Results: A total of 297 GAS isolates were collected. The susceptibility of the isolates to penicillin, ceftriaxone, and levofloxacin was 100%. The resistance rate to erythromycin and clindamycin was 98.3 and 96.6%, respectively. The dominant emm types were emm12 (65.32%), emm1 (27.61%), emm75 (2.69%), and emm89 (1.35%). Of the 297 isolates, 290 (97.64%) carried the ermB gene, and 5 (1.68%) carried the mefA gene, while none carried the ermA gene. The most common superantigen genes identified from GAS isolates were smeZ (96.97%), speC (92.59%), speG (91.58%), ssa (85.52%), speI (54.55%), speH (52.19%), and speA (34.34%). Isolates with the genotype emm1 possessed speA, speC, speG, speJ, speM, ssa, and smeZ, while emm12 possessed speC, speG, speH, speI, speM, ssa, and smeZ superantigens. Conclusions: The prevalent strain of GAS isolates in Beijing has a high resistance rate to macrolides; however, penicillin can still be the preferred antibiotic for treatment. Erythromycin resistance was predominantly mediated by ermB. The common emm types were emm12 and emm1. There was a correlation between emm and the superantigen gene. Thus, long-term monitoring and investigation of the emm types and superantigen genes of GAS prevalence are imperative.

Streptococcal Pyrogenic Exotoxin Genes SpeA and SpeB in Isolates of <i>Streptococcus pyogenes</i> from Children with Pharyngitis, Gezira State, Sudan

“…The Superantigen SpeA was found in 33.3% of this study and SpeA was 36.8% in the study of [5]. Also, this result is similar to [13] study which showed the percentage of SpeA gene was 34.34%. A study of [9] showed a lower percentage of SpeA (17.2%)…”

“…Streptococcus pyogenes is sensitive to penicillin; different studies worldwide showed that like [10] study from Iran, [11] study from Senegal, [12] study from Ethiopia, [13] study from China and our study also showed that which confirms the penicillin is still the drug of choice for the treatment of GAS pharyngitis.…”

Molecular Identification of <i>Streptococcus pyogenes</i> in Isolates from Children with Pharyngitis, Gezira State, Sudan 2022

“…Ethiopia, [15] study from China and our study also showed that which confirm the penicillin is still the drug of choice for the treatment of GAS pharyngitis.…”

Systematic review of the prevalence and nature of drug‐related problems in paediatric patients

“…Many studies have found that antibiotics result in a higher DRP incidence than other drugs. This may be due to antibiotics, which can be used prophylactically, particularly for patients diagnosed with severe malnutrition, as these patients are at risk of developing infection even with a single microorganism 43 ; the absence of national prescribing guidelines and the prevalence of antibiotic resistance also contribute to the high levels of broad‐spectrum antibiotics prescribed in paediatric populations. 44 , 45 Many studies have shown that the high prevalence of DRPs may be attributed to the number of prescribed drugs.…”