Beta-hemolytic streptococcal infections in trauma patients
P Mathur1, N Bhardwaj2, G Gupta3
1Department of Laboratory Medicine, Jai Prakash Narain Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, 110029, India. purvamathur@yahoo.co.in.
Summary
Molecular epidemiology of beta-hemolytic streptococci (βHS) in Indian trauma patients reveals Group A Streptococcus (GAS) as the most common cause. High diversity in M protein gene (emm) types and significant resistance to tetracycline and erythromycin were observed in GAS isolates.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Molecular Epidemiology
Background:
- Beta-hemolytic streptococci (βHS) are significant human pathogens.
- The molecular epidemiology of βHS infections in trauma patients remains understudied.
- This study addresses this gap in a Level 1 trauma center in India.
Purpose of the Study:
- To investigate the molecular and clinical epidemiology of βHS infections in trauma patients.
- To identify the prevalent species and virulence factors of βHS.
- To determine antimicrobial resistance patterns and M protein gene (emm) types of Group A Streptococcus (GAS).
Main Methods:
- Isolation and identification of 117 βHS clinical isolates from trauma patients.
- Antimicrobial susceptibility testing.
- Polymerase chain reaction (PCR) for exotoxin virulence genes and emm gene sequencing for GAS typing.
Main Results:
- Group A Streptococcus (GAS) was the predominant isolate (64%), followed by Group G Streptococcus (GGS) (23%).
- High prevalence of exotoxin genes speB, speF, and speG in GAS; smeZ detected in GAS and GGS.
- Significant resistance to tetracycline (69%) and erythromycin (33%) in GAS; 25 emm types identified, with emm 11 being most common.
Conclusions:
- βHS infections in Indian trauma patients involve both GAS and non-GAS strains.
- GAS isolates exhibit high emm type diversity and substantial macrolide and tetracycline resistance.
- No correlation found between disease severity and exotoxin gene production.
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