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

A Stathi1, J Papaparaskevas, L Zachariadou

  • 1Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
|August 30, 2008
PubMed

Insights

The first Greek study on invasive Streptococcus pyogenes found emm types 1 and 12 were most common. Resistance to erythromycin and tetracycline was observed in some strains, highlighting the need for ongoing surveillance.

Area of Science:

  • Microbiology
  • Epidemiology
  • Infectious Diseases

Background:

  • Invasive Streptococcus pyogenes disease (iGAS) poses a significant public health concern globally.
  • Systematic surveillance is crucial for understanding the epidemiology and guiding treatment strategies for iGAS.
  • Data on iGAS in Greece were previously limited, necessitating a comprehensive surveillance effort.

Purpose of the Study:

  • To conduct the first systematic multicentre surveillance of invasive Streptococcus pyogenes disease in Greece.
  • To identify prevalent emm types and assess antimicrobial resistance patterns.
  • To characterize the genetic diversity of invasive Streptococcus pyogenes isolates.

Main Methods:

  • Collection of 101 Streptococcus pyogenes isolates from invasive infections across Greece between 2003 and 2005.
  • emm typing to determine the genetic type of each isolate.
  • Antimicrobial susceptibility testing for erythromycin and tetracycline.
  • Pulsed-field gel electrophoresis (PFGE) for chromosomal fingerprinting and subtyping.

Main Results:

  • emm types 1 and 12 were the most prevalent, accounting for 27 and 9 cases, respectively.
  • A total of 26 other emm types were identified among the remaining 65 isolates.
  • Erythromycin resistance was observed in 12 isolates, primarily mediated by mef(A), with all emm type 1 strains remaining susceptible.
  • Tetracycline resistance, mainly due to tet(M), was detected in 26 isolates.
  • PFGE analysis revealed 50 distinct chromosomal fingerprints, further differentiating ten emm types.

Conclusions:

  • emm types 1 and 12 are key players in invasive Streptococcus pyogenes disease in Greece.
  • The presence of antibiotic resistance, particularly to erythromycin and tetracycline, necessitates careful treatment selection.
  • Genetic diversity exists within invasive Streptococcus pyogenes populations in Greece, requiring continued monitoring.

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