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Epidemiological characterization of Streptococcus pyogenes isolated from patients with multiple onsets of pharyngitis

Taiji Ogawa1, Yutaka Terao, Hiroshi Sakata

  • 1Department of Oral and Molecular Microbiology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan.

FEMS Microbiology Letters
|March 3, 2011
PubMed

Insights

Recurrent Streptococcus pyogenes pharyngitis strains show increased antibiotic resistance, particularly to macrolides and lincosamides. Distinguishing recurrence from reinfection is crucial for effective treatment of streptococcal pharyngitis.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Genetics

Background:

  • Streptococcus pyogenes is a common cause of pharyngitis.
  • Antibiotic treatment failures in streptococcal pharyngitis have been reported.
  • Understanding recurrent S. pyogenes strains is important for clinical management.

Purpose of the Study:

  • To investigate the characteristics of recurrent Streptococcus pyogenes strains from Japanese patients.
  • To differentiate between true recurrence and reinfection in persistent streptococcal pharyngitis.
  • To assess the antibiotic susceptibility profiles of recurrent S. pyogenes isolates.

Main Methods:

  • Collection of 93 S. pyogenes isolates from patients with recurrent pharyngitis in Japan.
  • Genetic characterization including M-typing and spe genotyping.
  • Pulsed field gel electrophoresis (PFGE) for strain differentiation.
  • Antibiotic susceptibility testing for macrolides and lincosamides.

Main Results:

  • M-type and PFGE analysis indicated different strains in 11 of 49 recurrent episodes, suggesting reinfection.
  • Spe genotyping showed strain correspondence in 22 cases, indicating true recurrence.
  • Over half of the recurrent isolates exhibited resistance to macrolides and lincosamides, a higher proportion than in initial infections.

Conclusions:

  • Recurrence and reinfection are often conflated in diagnosing persistent streptococcal pharyngitis.
  • Recurrent S. pyogenes strains demonstrate reduced susceptibility to common antibiotics.
  • Clinical caution regarding antibiotic use is warranted due to increasing resistance patterns.

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