Prevalence of emm types 1 and 12 from invasive Streptococcus pyogenes disease in Greece—results of enhanced surveillance

Stathi, Angeliki; Papaparaskevas, J.; Zachariadou, Levantia; Pangalis, A.; Nj, Legakis; Tseleni-Kotsovili, A.; Tassios, Panayotis T.

doi:10.1111/j.1469-0691.2008.02032.x

Cited by 10 publications

(13 citation statements)

References 22 publications

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“…The majority (65%) of erythromycin-resistant isolates belonged to emm types 58 and 92. Other studies have found erythromycin resistance associated with emm types 4, 11, and 28 (15,16,18,21,42). Resistance to both tetracycline and erythromycin was associated with emm types 58 and 94, of which emm58 was more common (78%).…”

Section: Discussionmentioning

confidence: 92%

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Epidemiology of Invasive Group A Streptococcal Disease in Alaska, 2001 to 2013

et al. 2016

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The Arctic Investigations Program (AIP) began surveillance for invasive group A streptococcal (GAS) infections in Alaska in 2000 as part of the invasive bacterial diseases population-based laboratory surveillance program. Between 2001 and 2013, there were 516 cases of GAS infection reported, for an overall annual incidence of 5.8 cases per 100,000 persons with 56 deaths (case fatality rate, 10.7%). Of the 516 confirmed cases of invasive GAS infection, 422 (82%) had isolates available for laboratory analysis. All isolates were susceptible to penicillin, cefotaxime, and levofloxacin. Resistance to tetracycline, erythromycin, and clindamycin was seen in 11% (n ‫؍‬ 8), 5.8% (n ‫؍‬ 20), and 1.2% (n ‫؍‬ 4) of the isolates, respectively. A total of 51 emm types were identified, of which emm1 (11.1%) was the most prevalent, followed by emm82 (8.8%), emm49 (7.8%), emm12 and emm3 (6.6% each), emm89 (6.2%), emm108 (5.5%), emm28 (4.7%), emm92 (4%), and emm41 (3.8%). The five most common emm types accounted for 41% of isolates. The emm types in the proposed 26-valent and 30-valent vaccines accounted for 56% and 78% of all cases, respectively. GAS remains an important cause of invasive bacterial disease in Alaska. Continued surveillance of GAS infections will help improve understanding of the epidemiology of invasive disease, with an impact on disease control, notification of outbreaks, and vaccine development.

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Section: Discussionmentioning

confidence: 92%

“…To date, Ͼ200 different emm types have been reported. In most countries, emm types 1, 3, 12, and 28 have traditionally been associated with invasive GAS disease (9,(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22).…”

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confidence: 99%

Epidemiology of Invasive Group A Streptococcal Disease in Alaska, 2001 to 2013

et al. 2016

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“…1,2 The M phenotype is the predominant phenotype in many countries, 7,15,19,34,37 whereas iMLS is the most common phenotype in some countries 4,14,25,30 . Differences among the countries could be due to different antibiotic using patterns.…”

Section: Discussionmentioning

confidence: 99%

“…3,10 In some studies, tetracycline resistance in S. pyogenes was found to be associated with the tetM gene and, less frequently, with the tetO gene. 16,29,34 Since tetracycline resistance genes can reside in mobile genetic elements that carry macrolide resistance genes, the cooccurrence of resistance to both classes of drugs is possible. 5 Particularly, a linkage between erm(B) and tet(M) is well known.…”

Section: Discussionmentioning

confidence: 99%

Macrolide and Tetracycline Resistance andemmType Distribution ofStreptococcus pyogenesIsolates Recovered from Turkish Patients

Dündar

Sayan

Tamer

2010

Microbial Drug Resistance

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The aims of this study were to determine the susceptibilities to macrolide and tetracycline antibiotics and emm type distribution of Streptococcus pyogenes strains isolated in the Kocaeli University Hospital, Turkey. A total of 127 S. pyogenes clinical isolates were tested. Eleven (9%) isolates were resistant to erythromycin, and 23 (18%) isolates were resistant to tetracycline. Ten of the erythromycin-resistant isolates were also resistant to tetracycline. By the triple-disk test, all erythromycin-resistant isolates showed the inducible macrolide-lincosamidestreptogramin-C phenotype and harbored erm(TR) gene. tet(O) was the most common tetracycline resistance gene. Among erythromycin-tetracycline coresistant isolates, seven harbored the tet(O) gene. emm 4, emm 1, emm 2,114, and emm 89 were the most common emm types. These isolates were more susceptible to erythromycin. There was considerable emm type heterogeneity in macrolide or tetracycline resistant isolates. According to our knowledge, this is the first study in which emm type distribution is investigated in Turkey. More comprehensive studies are needed to obtain true information about the epidemiology of macrolide and tetracycline resistance and emm type distribution in Turkey.

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“…This surveillance covered both adult and paediatric cases and presented for the first time data from Greece, as part of the Strep-EURO initiative [1]. Preliminary observations regarding the epidemiology within each age group led us to further investigate possible epidemiological and clinical differences of iGAS infections between the two groups, during the extended period of 2003-2007, as similar comparable data are scarce in the literature and the majority of previous studies simply presented results on overall iGAS infections, or compared invasive and superficial infections [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Differences in the epidemiology between paediatric and adult invasiveStreptococcus pyogenesinfections

Zachariadou

Stathi

et al. 2013

Epidemiol. Infect.

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In order to investigate for possible differences between paediatric and adult invasive Streptococcus pyogenes (iGAS) infections, a total of 142 cases were identified in 17 Greek hospitals during 2003-2007, of which 96 were children and 46 adults. Bacteraemia, soft tissue infections, streptococcal toxic shock syndrome (STSS), and necrotizing fasciitis were the main clinical presentations (67·6%, 45·1%, 13·4%, and 12·0% of cases, respectively). Bacteraemia and lymphadenitis were significantly more frequent in children (P=0·019 and 0·021, respectively), whereas STSS was more frequent in adults (P=0·017). The main predisposing factors in children were varicella and streptococcal pharyngotonsillitis (25% and 19·8%, respectively), as opposed to malignancy, intravenous drug abuse and diabetes mellitus in adults (19·6%, 15·2% and 10·9%, respectively). Of the two dominant emm-types, 1 and 12 (28·2% and 8·5%, respectively), the proportion of emm-type 12 remained stable during the study period, whereas emm-type 1 rates fluctuated considerably. Strains of emm-type 1 from children were associated with erythromycin susceptibility, STSS and intensive-care-unit admission, whereas emm-type 12 isolates from adults were associated with erythromycin and clindamycin resistance. Finally, specific emm-types were detected exclusively in adults or in children. In conclusion, several clinical and epidemiological differences were detected, that could prove useful in designing age-focused strategies for prevention and treatment of iGAS infections.

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Prevalence of emm types 1 and 12 from invasive Streptococcus pyogenes disease in Greece—results of enhanced surveillance

Cited by 10 publications

References 22 publications

Epidemiology of Invasive Group A Streptococcal Disease in Alaska, 2001 to 2013

Epidemiology of Invasive Group A Streptococcal Disease in Alaska, 2001 to 2013

Macrolide and Tetracycline Resistance andemmType Distribution ofStreptococcus pyogenesIsolates Recovered from Turkish Patients

Differences in the epidemiology between paediatric and adult invasiveStreptococcus pyogenesinfections

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