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. 2007 Jul;45(7):2249-56.
doi: 10.1128/JCM.00513-07. Epub 2007 May 9.

emm Types, virulence factors, and antibiotic resistance of invasive Streptococcus pyogenes isolates from Italy: What has changed in 11 years?

Roberta Creti  1 , Monica Imperi, Lucilla Baldassarri, Marco Pataracchia, Simona Recchia, Giovanna Alfarone, Graziella Orefici
Affiliations

emm Types, virulence factors, and antibiotic resistance of invasive Streptococcus pyogenes isolates from Italy: What has changed in 11 years?

Roberta Creti et al. J Clin Microbiol. 2007 Jul.

Abstract

To investigate the epidemiology and characteristics of invasive group A streptococcal (GAS) disease over 11 years in Italy, this study compared the emm types and the superantigen toxin genes speA and speC as well as the erythromycin, clindamycin, and tetracycline susceptibilities of 207 invasive GAS strains collected during two national enhanced surveillance periods (1994 to 1996 and 2003 to 2005) and the time between each set of surveillance periods. The present study demonstrated that emm1 strains were consistently responsible for about 20% of invasive GAS infections, while variations in the frequencies of the other types were noted, although the causes of most cases of invasive infections were restricted to emm1, emm3, emm4, emm6, emm12, and emm18. During the 1994 to 1996 surveillance period, an emm89 epidemic clone spread across the northern part of Italy. A restricted macrolide resistance phenotype-type distribution of the bacteriophage-encoded speA toxin as well as of macrolide resistance genes was noted over time. Indeed, the recent acquisition of macrolide resistance in previously susceptible emm types was observed.

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Figures

FIG. 1.
FIG. 1.
Distribution of emm types among GAS strains isolated from patients with invasive infections during the 1994 to 1996 enhanced surveillance (top), from 1997 to 2002 (middle), and during the Strep-EURO survey (2003 to 2005) (bottom).
FIG. 2.
FIG. 2.
Incidence of macrolide resistance and erm(B), erm(A) subclass (TR), and mef(A) genes among GAS strains isolated from patients with invasive infections during the 1994 to 1996 enhanced surveillance (left), from 1997 to 2002 (middle), and during the Strep-EURO survey (2003 to 2005) (right).
FIG. 3.
FIG. 3.
Distribution of invasive GAS isolates collected during the Strep-EURO survey according to the MICs of erythromycin (A) and clindamycin (B). M, IR (inducible resistance), and CR (constitutive resistance) indicate the phenotype.
FIG. 4.
FIG. 4.
Incidence of speA (dark gray) and speC (light gray) genes of invasive GAS strains isolated during the three indicated periods.
See this image and copyright information in PMC

References

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