Group A Streptococcus vulvovaginitis in Spain, 2011-2023: antibiotic resistance and emm-type distribution

An increase in Group A Streptococcus vulvovaginitis was detected in 2023: The average number of cases per year was 13 during 2011-2017. Twenty-five and 27 cases were reported in 2018 and 2019 followed by a decline coinciding with the COVID-19 pandemic. The 2023 increase surpassed previous data. The most frequent resistances were to erythromycin (11.3%;) and tetracycline (8.8%). Eleven different emm-types were detected among 30 GAS isolated in 2023: emm 1 was predominant (36.7%) followed by emm 89 (20%), emm 87 (10%) and emm 28 (6.7%). GAS should be increasingly considered in women with vulvovaginitis.