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Multiplex PCR Assay for Typing of Staphylococcal Cassette Chromosome Mec Types I to V in Methicillin-resistant Staphylococcus aureus
Published on: September 5, 2013
Prevalence and emm typing of multi-drug resistant Streptococcus pyogenes in tertiary care health settings
Abdul Basit1, Mubbashir Hussain2, Muhammad Qasim1
1Department of Microbiology, Kohat University of Science and Technology (KUST), Kohat, 26000, Pakistan.
Background:
Streptococcus pyogenes causes diverse infections, including pharyngitis and invasive diseases. Emerging resistance to β-lactams and macrolide poses a significant public health threat in developing countries. This study examines the prevalence, antibiotic susceptibility, and emm types of S. pyogenes strains isolated from hospitals in Khyber Pakhtunkhwa (KP), Pakistan.
Methods:
A total of 4,062 clinical samples, including throat swabs, blood, pus, and biopsies, were collected from eight hospitals. S. pyogenes was isolated and identified using standard microbiological techniques. Antibiotic susceptibility tests and Minimum Inhibitory Concentrations (MIC) were investigated using the disc diffusion method and Epsilometer test (E-test), respectively. PCR and DNA sequencing were used to determine the emm typing of the isolates.
Results:
Of the 4,062 samples, 471 were positive for S. pyogenes (11.5%). The most common emm types identified were emm12 (16%), emm4 (13%), and emm1 (12%). Isolates from the throat samples predominantly yielded emm1. However, emm12 was most common in biopsy and blood samples, and emm4 was frequently isolated from pus. High resistance to erythromycin (8%) and tetracycline (8%) and no resistance to meropenem, vancomycin, and teicoplanin were recorded. Penicillin resistance ranged from 0.6% to 7.2%, with MIC distribution between 0.07-2.9 mg/L. Factors including low financial status (AOR = 3.18, 95% CI = 1.60-6.32, P = 0.05), self-medication with unprescribed antibiotics (AOR = 5.45, 95% CI = 2.60-11.22, P = 0.04), and presence of comorbidities (AOR = 9.13, 95% CI = 2.54-26.54, P = 0.03) were significantly associated with increased risk of infection.
Conclusion:
The emm typing results revealed significant genetic diversity among S. pyogenes isolates, with emm12, emm4, and emm1 being the most prevalent types in KP. This diversity, along with the observed antibiotic resistance patterns, underscores the need for ongoing surveillance and targeted treatment strategies to effectively manage S. pyogenes infections in the region.
Insights
Streptococcus pyogenes infections are common in Pakistan, with prevalent emm types emm12, emm4, and emm1. Antibiotic resistance is a concern, necessitating targeted surveillance and treatment strategies for this pathogen.
Area of Science:
- Microbiology
- Infectious Diseases
- Public Health
Background:
- Streptococcus pyogenes causes various infections, posing a public health threat due to emerging antibiotic resistance.
- This study investigated S. pyogenes in Khyber Pakhtunkhwa (KP), Pakistan, focusing on prevalence, antibiotic susceptibility, and emm types.
Purpose of the Study:
- To determine the prevalence and antibiotic susceptibility of S. pyogenes isolates.
- To identify the emm types of S. pyogenes strains circulating in KP, Pakistan.
- To understand the risk factors associated with S. pyogenes infections.
Main Methods:
- Collected 4,062 clinical samples from eight hospitals in KP.
- Isolated and identified S. pyogenes using standard microbiological techniques.
- Performed antibiotic susceptibility testing (disc diffusion, E-test), emm typing (PCR, DNA sequencing), and statistical analysis for risk factors.
Main Results:
- Identified S. pyogenes in 11.5% (471/4062) of samples.
- Most common emm types were emm12 (16%), emm4 (13%), and emm1 (12%), with type distribution varying by sample source.
- Observed high resistance to erythromycin (8%) and tetracycline (8%), with low penicillin resistance (0.6-7.2%). Low financial status, self-medication, and comorbidities were significant risk factors.
Conclusions:
- Significant genetic diversity of S. pyogenes was found in KP, with emm12, emm4, and emm1 as dominant types.
- Observed antibiotic resistance patterns highlight the need for continuous surveillance.
- Targeted treatment strategies are crucial for effective management of S. pyogenes infections in the region.
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