1887

Abstract

Currently there are 93 validated M serotypes of , Lancefield group A streptococcus (GAS), and >130 genotypes. A marked increase in the number of non-typable GAS isolates (2 % in 2000, 4 % in 2001 and 9 % in 2002) from invasive disease cases referred to the authors' reference laboratory was noted during 2000–2002. A total of 217 (92 %) were from blood cultures, 14 (6 %) from deep abscesses and five (2 %) from aspirates. The clinical manifestations included bacteraemia, septicaemia, cellulitis, meningitis, necrotizing fasciitis and toxic-shock syndrome. In order to establish whether this increase was due to the emergence of novel types or the unavailability of M-typing sera, these isolates were subjected to sequencing. A total of 144 isolates (61 %) belonged to M types for which sera were no longer available; 112 (48 %) belonged to higher M types, including 83.1 (9 %), 94 (8 %) 87 (6 %) and 89 (6 %); and 32 (13 %) belonged to lower M types that were not commonly isolated in the UK, and included M25, M43, M49, M64, M73 and M74. Sixty-six (28 %) of the isolates belonged to newly designated types. Other isolates belonged to the novel types st2147, STNS1033 and st854, recently registered in the Centers for Disease Control (CDC) database by other laboratories. One novel type, st2161, was isolated from an injecting drug user. There were differences in the type distribution of these isolates according to geographic location. However, 90 % of 93, one of seven predominant types identified amongst the collection of M non-typable (MNT) isolates, were isolated from the London region.

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2006-10-01
2024-03-29
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References

  1. Beachey E. H., Seyer J. M., Dale J. B., Simpson W. A., Kang A. H. 1981; Type specific protective immunity evoked by synthetic peptide of Streptococcus pyogenes M protein. Nature 292:427–457
    [Google Scholar]
  2. Beall B., Facklam R., Thompson T. 1996; Sequence emm -specific PCR products for routine and accurate typing of group A streptococci. J Clin Microbiol 41:4655–4659
    [Google Scholar]
  3. Beall B., Facklam R., Hoenes T., Schwartz B. 1997; Survey of emm gene sequences and T-antigen types from systemic Streptococcus pyogenes infection isolates collected in San Francisco. California; Atlanta, Georgia; and Connecticut in: 1994 and 1995 J Clin Microbiol 35:1231–1235
    [Google Scholar]
  4. Beall B., Facklam R. R., Elliott J. A., Franklin A. R., Hoenes T., Jackson D., Lanclair L., Thompson T., Vishwanathan R. 1998; Streptococcal emm types associated with T-agglutination type and the use of conserved emm gene restriction fragment pattern for subtyping group A streptococci. J Med Microbiol 47:893–898 [CrossRef]
    [Google Scholar]
  5. Bernaldo de Quiros J. C., Monreno S., Cercenado E., Diaz D., Berenguer J., Miralles P., Catalan P., Bouza E. 1997; Group A streptococcal bacteraemia. A 10 year prospective study. Medicine (Baltimore 76:238–248 [CrossRef]
    [Google Scholar]
  6. Bohlen L. M., Muhlemann K., Dubuis O., Aebi C., Tauber M. G. 2000; Outbreak among drug users caused by a clonal strain of group A streptococcus. Emerg Infect Dis 6:175–179
    [Google Scholar]
  7. Colman G. A., Tanna A., Efstratiou A., Gaworzewska E. T. 1993; The serotypes of Streptococcus pyogenes present in Britain during 1980–1990 and their association with disease. J Med Microbiol 39:165–178 [CrossRef]
    [Google Scholar]
  8. Efstratiou A., Emery M., Lamangi T. L., Tanna A., Warner M., George R. C. 2003; Increasing incidence of group A streptococcal infections amongst injecting drug users in England and Wales. J Med Microbiol 52:525–526 [CrossRef]
    [Google Scholar]
  9. Engler K. H., Perrett K. 2004; Group A streptococcal bacteraemia in Yorkshire and the Humberside: evidence of another problematic infection among injecting drug users. Commun Dis Public Health 7:123–127
    [Google Scholar]
  10. Facklam R. R., Edwards I. R. 1979; A reference laboratory's investigations of proposed M type strains of Streptococcus pyogenes , capsular types of S. agalactiae and new group antigens of streptococci. In Pathogenic Streptococci pp  251–253 Edited by Parker M. T. Chertsey, UK: Reedbooks;
    [Google Scholar]
  11. Facklam R., Beall B., Efstratiou A. 13 other authors 1999; emm typing and validation of provisional M types for group A streptococci. Emerg Infect Dis 5:247–253 [CrossRef]
    [Google Scholar]
  12. Fischetti V. A. 1989; Streptococcal M protein: Molecular design and biological behaviour. Clin Microbiol Rev 2:285–314
    [Google Scholar]
  13. Johnson D. R., Kaplan E. I. 1995; A review of the correlation of T-agglutination patterns and M-protein typing and opacity factor production in the identification of group A streptococci. J Med Microbiol 38:311–315
    [Google Scholar]
  14. Johnson D. R. 1996 Laboratory Diagnosis of Group A Streptococcal Infections Geneva: World Health Organization;
    [Google Scholar]
  15. Lechot P., Schaad H. J., Graf S., Tauber M., Muhlemann K. 2001; Group A streptococcus clones causing repeated epidemics and endemic disease in intravenous drug users. Scand J Infect Dis 33:41–46 [CrossRef]
    [Google Scholar]
  16. Maxted W. R., Widdowson J. P. 1972; The protein antigens of group A streptococci. In Streptococci and Streptococcal Diseases pp  251–266 Edited by Wannamaker L. W., Matsen J. M. New York: Academic Press;
    [Google Scholar]
  17. Moody M. D., Padula J., Lizana D., Hall C. T. 1996; Epidemiologic characterisation of group A streptococci by T-agglutination and M-precipitation tests in the public health laboratory. Health Lab Sci 2:149–162
    [Google Scholar]
  18. Moses A. E., Hidalgo-Grass C., Dann-Goor M., Jaffe J., Shetzigovsky I., Ravins M., Korenman Z., Cohen-Poradosu R., Nir-Paz R. 2003; emm typing of M nontypeable invasive group A streptococcal isolates in Israel. J Clin Microbiol 10:4655–4659
    [Google Scholar]
  19. Navarro V. J., Axelrod P. I., Pinover W., Hockfield H. S., Kostman J. R. 1993; A comparison of Streptococcus pyogenes (group A streptococcal) bacteraemia at an urban and a suburban hospital. The importance of intravenous drug use. Arch Intern Med 153:2679–2684 [CrossRef]
    [Google Scholar]
  20. Saunders N. A., Hallas G., Gaworzewska E. T., Metherell L., Efstratiou A., Hookey J. V., George R. C. 1997; PCR-enzyme-linked immunosorbent assay and sequencing as an alternative to serology for M-antigen typing of Streptococcus pyogenes . J Clin Microbiol 35:2689–2691
    [Google Scholar]
  21. Tanaka D., Gyobu Y., Kodama H., Isobe J., Hosorogi S., Hiramoto Y., Karasawa T., Nakamura S. 2002; emm typing of group A streptococcus clinical isolates: identification of dominant types for throat and skin isolates. Microbiol Immunol 46:419–423 [CrossRef]
    [Google Scholar]
  22. Teixeira L. M., Barros R. R., Castro A. C. & 7 other authors; 2001; Genetic and phenotypic features of Streptococcus pyogenes strains isolated in Brazil that harbour new emm sequences. J Clin Microbiol 39:3290–3295 [CrossRef]
    [Google Scholar]
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