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[Serotype distribution and antimicrobial susceptibility of group A streptococci (Streptococcus pyogenes) isolated in
1National Institute of Preventive Medicine, Department of Health, Taipei, Taiwan, R.O.C.
Abstract:
T-protein serotypes and antimicrobial susceptibility of a total of 139 group A streptococci (GAS) strains isolated in Taiwan area in 1993 and during the outbreak of scarlet fever in 1994 were analyzed. All strains were T-typable, and T12 (42.46%) and T4 (38.85%) were the dominant T types. According to the results of analysis of antimicrobial susceptibility, all GAS strains were divided into 9 resistotypes, A (all susceptible), B (resistant to tetracycline), C (resistant to erythromycin and tetracycline), D (resistant to chloramphenicol and tetracycline), E (resistant to chloramphenicol and clindamycin), F (resistant to chloramphenicol, clindamycin and tetracycline), G (resistant to clindamycin, erythromycin and tetracycline), H (resistant to chloramphenicol, clindamycin, erythromycin and tetracycline), and I (resistant to chloramphenicol, clindamycin, erythromycin, tetracycline and vancomycin). Type B (37.42%) was the dominant type. Type A (25.91%), and type H (26.63%) also appered with high incidence. Most of strains isolated from Mid-Taiwan were type H. Only one strain, that was isolated in I-lan, was resistant to vancomycin, in addition to resistant to chloramphenicol, clindamycin, erythromycin, and tetracycline. All strains were susceptible to penicillin G, ampicillin, and ceftriaxone. Some strains were resistant to chloramphenicol (32.38%), clindamycin (30.22%), erythromycin (31.66%), tetracycline (73.39%), and vancomycin (0.70%). During the outbreak of scarlet fever in 1994, the dominant T types of strains isolated in North-Taiwan and Mid-Taiwan were T4 and T12, respectively, and the major resistotypes of those strains were B and H types, respectively. These clues suggested that the outbreaks occurring in North-Taiwan and Mid-Taiwan may have no epidemiological linkage between each other.
Insights
Group A Streptococcus (GAS) T-protein serotypes and antimicrobial resistance patterns were analyzed in Taiwan. T12 and T4 were dominant, with tetracycline resistance most common, suggesting distinct regional outbreaks.
Area of Science:
- Microbiology
- Epidemiology
- Antimicrobial Resistance
Context:
- Group A Streptococcus (GAS) infections, including scarlet fever, pose public health challenges.
- Understanding the T-protein serotypes and antimicrobial susceptibility of GAS is crucial for effective treatment and outbreak management.
- This study analyzes GAS strains from Taiwan, focusing on data from 1993 and the 1994 scarlet fever outbreak.
Purpose:
- To characterize the T-protein serotypes of GAS strains isolated in Taiwan.
- To determine the antimicrobial susceptibility patterns of these GAS strains.
- To investigate potential epidemiological links between GAS outbreaks in different regions of Taiwan.
Summary:
- A total of 139 GAS strains were analyzed for T-protein serotypes, with T12 (42.46%) and T4 (38.85%) being dominant.
- Antimicrobial susceptibility testing revealed nine resistotypes, with Type B (tetracycline resistance) being most prevalent (37.42%).
- High incidences of Type A (25.91%) and Type H (26.63%) resistotypes were observed, with Type H predominant in Mid-Taiwan.
- All strains remained susceptible to penicillin G, ampicillin, and ceftriaxone.
- One strain exhibited vancomycin resistance, alongside resistance to multiple other antibiotics.
- Analysis of strains from the 1994 scarlet fever outbreak in North and Mid-Taiwan indicated distinct T types and resistotypes (T4/Type B in North, T12/Type H in Mid), suggesting no epidemiological linkage.
Impact:
- Provides essential data on GAS epidemiology and antibiotic resistance in Taiwan.
- Highlights the prevalence of specific T types and resistotypes, informing clinical treatment strategies.
- Suggests distinct origins or transmission routes for scarlet fever outbreaks in different Taiwanese regions.
- Identifies the emergence of vancomycin resistance in a GAS strain, warranting further surveillance.