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A comprehensive analysis of antimicrobial resistance of clinical emm89 Streptococcus pyogenes in Japan

Weichen Gong1,2, Masayuki Ono1,3, Masaya Yamaguchi1,3,4,5,6

  • 1Department of Microbiology, Osaka University Graduate School of Dentistry, Osaka, Japan.

Jac-Antimicrobial Resistance
|February 20, 2025
PubMed
Abstract

Insights

High rates of Streptococcus pyogenes resistance to azithromycin and clindamycin were found in Japan. This antimicrobial resistance (AMR) in emm89 strains, linked to non-invasive infections, necessitates new treatment strategies.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Genomics

Background:

  • Streptococcus pyogenes causes diverse infections, from pharyngitis to invasive disease.
  • Antimicrobial resistance (AMR) in S. pyogenes is a growing global concern, limiting treatment options.
  • Specific emm types, particularly emm89, are prevalent in Japan.

Purpose of the Study:

  • To investigate the antimicrobial resistance patterns of prevalent S. pyogenes emm types in Japan.
  • To identify specific AMR-associated genes contributing to resistance.
  • To assess the correlation between AMR and infection phenotypes.

Main Methods:

  • Analysis of 368 S. pyogenes isolates (311 emm89, 57 other emm types) from Japanese patients.
  • Determination of minimum inhibitory concentrations for seven antibiotics, including azithromycin (AZM) and clindamycin.
  • Whole-genome sequencing to screen for AMR-associated genes.

Main Results:

  • 47 resistant strains were identified; 91.49% showed resistance to AZM and/or clindamycin.
  • A significant correlation was found between non-invasive phenotypes and AMR.
  • Genes ermT, folP, and lmrP were widely distributed in emm89 strains; tetO, soxS, and mel were found in emm4 strains.

Conclusions:

  • High prevalence of S. pyogenes resistance to AZM and clindamycin in Japan poses a public health threat.
  • The findings highlight the urgent need for developing novel antimicrobial therapies.
  • Understanding AMR mechanisms in prevalent S. pyogenes strains is crucial for effective treatment strategies.

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