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Epidemiology and molecular characterization of macrolide-resistant Streptococcus pyogenes in Taiwan.
- Source :
-
Journal of clinical microbiology [J Clin Microbiol] 2014 Feb; Vol. 52 (2), pp. 508-16. Date of Electronic Publication: 2013 Dec 04. - Publication Year :
- 2014
-
Abstract
- Our multicenter nationwide surveillance data indicated that erythromycin (ERY) resistance among group A Streptococcus (GAS) isolates in Taiwan declined from 53.1% in 1998 and 2000 to 14.6% in 2002 and 2004 and 10.7% in 2006 to 2010 (P < 0.01). The present study aimed to assess the epidemiology of GAS in Taiwan and identify factors associated with ERY resistance. All 127 ERY-resistant (ERY(r)) isolates and 128 randomly selected ERY-susceptible (ERY(s)) isolates recovered from 1998 to 2010 were emm typed. ERY(r) isolates were also characterized by ERY resistance phenotype and mechanisms and pulsed-field gel electrophoresis (PFGE). Multilocus sequence typing was performed on selected ERY(r) isolates. The predominant emm types in ERY(r) isolates were emm22 (n = 33, 26.0%), emm12 (n = 24, 18.9%), emm4 (n = 21, 16.5%), and emm106 (n = 15, 11.8%). In ERY(s) isolates, emm12 (n = 27, 21.9%), emm1 (n = 18, 14.1%), emm106 (n = 16, 12.5%), and emm11 (n = 9, 7.1%) predominated. The most common ERY resistance phenotype was the M phenotype (resistant to macrolides) (70.9%), with all but one isolate carrying mef(A), followed by the constitutive macrolide-lincosamide-streptogramin B resistance (cMLSB) phenotype (26.8%), with isolates carrying erm(B) or erm(TR). ERY(r) isolates of the emm12-sequence type 36 (ST36) lineage with the cMLSB phenotype were mostly present before 2004, while those of the emm22-ST46 lineage with the M phenotype predominated in later years. Recovery from respiratory (throat swab) specimens was an independent factor associated with ERY resistance. emm1 and emm11 GAS isolates were significantly associated with ERY(s), while emm22 was detected only in ERY(r) GAS. In addition, emm106 isolates were prevalent among the abscess/pus isolates, whereas emm12 isolates were strongly associated with a respiratory (throat) origin. In addition to identifying factors associated with ERY resistance in GAS, our study provides helpful information on the changing GAS epidemiology in Taiwan.
- Subjects :
- Adolescent
Adult
Antigens, Bacterial genetics
Bacterial Outer Membrane Proteins genetics
Carrier Proteins genetics
Child
Child, Preschool
Electrophoresis, Gel, Pulsed-Field
Female
Genotype
Humans
Infant
Infant, Newborn
Male
Microbial Sensitivity Tests
Multilocus Sequence Typing
Phenotype
Streptococcal Infections microbiology
Streptococcus pyogenes genetics
Streptococcus pyogenes isolation & purification
Taiwan epidemiology
Anti-Bacterial Agents pharmacology
DNA Fingerprinting
Drug Resistance, Bacterial
Macrolides pharmacology
Streptococcal Infections epidemiology
Streptococcus pyogenes classification
Streptococcus pyogenes drug effects
Subjects
Details
- Language :
- English
- ISSN :
- 1098-660X
- Volume :
- 52
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of clinical microbiology
- Publication Type :
- Academic Journal
- Accession number :
- 24478481
- Full Text :
- https://doi.org/10.1128/JCM.02383-13