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Meles HN, Aregawi BB, Gebregergis MW, Hailekiros H, Weldu Y, Thangaraju P, Thiruvengadam M, Alharbi NS, Saravanan M. Prevalence, antimicrobial susceptibility patterns and associated factors of Streptococcus pyogenes among apparently healthy school children in Mekelle city primary schools, Northern Ethiopia. Heliyon 2024; 10:e34769. [PMID: 39130447 PMCID: PMC11315190 DOI: 10.1016/j.heliyon.2024.e34769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 07/16/2024] [Accepted: 07/16/2024] [Indexed: 08/13/2024] Open
Abstract
Background Streptococcus pyogenes is one of the major public health concerns causing human infections ranging from skin and throat infections to acute rheumatic fever and post streptococcal glomerulonephritis. Moreover, nowadays drug-resistant strains of S. pyogenes are emerging and can be transmitted through apparently healthy carriers to susceptible individuals. Objective To assess the prevalence, antimicrobial susceptibility pattern and associated factors S. pyogenes among apparently healthy school children in Mekelle city primary schools, Northern Ethiopia. Methods A cross-sectional study was conducted among 504 apparently healthy school children from February to May 2018. We used structured questionnaire to collect socio-demographic data. Throat specimens were collected using sterile cotton Swab and transported for culture, antimicrobial susceptibility and identification of S. pyogenes according to standard operating procedures. Data were analyzed using Stata 13 for descriptive statistics, bivariate and multivariate logistic regression. P-value <0.05 was declared statistically significance. Results The mean age of the study participants was 11.5 years of which 55 % of them were females. The overall prevalence of S. pyogenes was 8.3 %. Being female, having low monthly income, weak personal hygiene, poor hand washing habit and crowded living style were significantly associated with the occurrence of S. pyogenes. The isolates of S. pyogenes showed resistance to Penicillin (69.1 %), Amoxicillin-Clavulanic acid (62 %), Ampicillin (54.6 %), Ceftriaxone (47.6 %), Tetracycline (14.4 %), Cefoxitin (7.2 %). About 57.15 % isolates were multidrug-resistant. Conclusions This study revealed that some isolates of S. pyogenes among the apparently healthy school children were resistant to commonly prescribed antibiotic agents and associated with hygienic conditions and living style. Therefore, it is recommended to practice antimicrobial susceptibility test to maintain rational antibiotic use and improve hygienic and hand washing practices to decrease the likelihood of carriage rate.
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Affiliation(s)
- Hadush Negash Meles
- Unit of Medical Microbiology and Immunology, Department of Medical Laboratory Sciences, College of Medicine and Health Science, Adigrat University, Adigrat, Ethiopia
| | - Brhane Berhe Aregawi
- Unit of Medical Parasitology and Entomology, Department of Medical Laboratory Sciences, College of Medicine and Health Science, Adigrat University, Adigrat, Ethiopia
| | - Miglas Welay Gebregergis
- Department of Midwifery, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia
| | - Haftamu Hailekiros
- Department of Medical Microbiology and Immunology, School of Medicine, Division of Biomedical Sciences, College of Health Science, Mekelle University, Mekelle, Ethiopia
| | - Yemane Weldu
- Department of Medical Microbiology and Immunology, School of Medicine, Division of Biomedical Sciences, College of Health Science, Mekelle University, Mekelle, Ethiopia
| | - Puganzhenthan Thangaraju
- Department of Pharmacology, All India Institute of Medical Sciences, Raipur, Chandigarh, 492099, India
| | - Muthu Thiruvengadam
- Department of Crop Science, College of Sanghuh Life Sciences, Konkuk University, Seoul, 05029, South Korea
| | - Naiyf S. Alharbi
- Department of Botany and Microbiology, College of Science, King Saud University, P. O. Box 2455, Riyadh, 11451, Saudi Arabia
| | - Muthupandian Saravanan
- AMR and Nanotherapeutics Lab, Department of Pharmacology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, 600 077, Tamilnadu, India
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Rahmadhany A, Advani N, Djer M, Handryastuti S, Safari D. Prevalence and predicting factors of Group A beta-hemolytic Streptococcus carrier state in primary schoolchildren. Ann Pediatr Cardiol 2021; 14:471-475. [PMID: 35527766 PMCID: PMC9075561 DOI: 10.4103/apc.apc_280_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 03/17/2021] [Accepted: 06/15/2021] [Indexed: 11/04/2022] Open
Abstract
Introduction: Aim and Objectives: Material and Methods: Results: Conclusion:
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Rafei R, Hawli M, Osman M, Dabboussi F, Hamze M. Distribution of emm types and macrolide resistance determinants among group A streptococci in the Middle East and North Africa region. J Glob Antimicrob Resist 2020; 22:334-348. [PMID: 32084609 DOI: 10.1016/j.jgar.2020.02.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 02/03/2020] [Accepted: 02/09/2020] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES The aim of this review was to provide an updated scenario on the epidemiology of group A streptococci (GAS) in the Middle East and North Africa (MENA) region with a special spotlight on the most prevalent emmtypes and macrolide resistance profiles. METHODS This review briefly summarises the disease burden for GAS in the MENA region. RESULTS Whilst the burden of invasive GAS infections is difficult to assess in the MENA region, the GAS prevalence ranged from 2.5% up to 42.4% in pharyngitis patients and from 2.4% up to 35.4% in healthy carriers.emm1, emm12, emm89, emm4, emm28 and emm3were responsible for the major GAS burden in the MENA region. The coverage rate of the new M protein-based vaccine candidate (30-valent) varied from 42% to 100% according to the country. The rate of erythromycin resistance differed substantially between countries from low to moderate or high. CONCLUSION These data add more shreds of evidence on the neglected GAS burden in the MENA region. Systematic surveillance of invasive GAS infections along with molecular characterisation of GAS isolates are strongly recommended to track the trends of circulating clones and to evaluate the potential coverage of vaccine candidates.
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Affiliation(s)
- Rayane Rafei
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Malaik Hawli
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Marwan Osman
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Fouad Dabboussi
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Monzer Hamze
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon.
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Othman AM, Assayaghi RM, Al-Shami HZ, Saif-Ali R. Asymptomatic carriage of Streptococcus pyogenes among school children in Sana'a city, Yemen. BMC Res Notes 2019; 12:339. [PMID: 31200755 PMCID: PMC6570875 DOI: 10.1186/s13104-019-4370-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 06/05/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Streptococcus pyogenes is the most frequent cause of pharyngitis and skin infections in children. It is also the causative agent of dangerous immune-complications such as rheumatic fever and rheumatic heart disease which are common in Yemen. The aim of this study was to determine the throat carriage rate of Streptococcus pyogenes among asymptomatic school children in Sana'a city. RESULTS A cross-sectional study was conducted from December to March of years 2012-2016. A total of 813 asymptomatic school children whose antistreptolysin O test was negative were included. The mean age of the students was 10.5 ± 2.8 years with a range from 5 to 15 years old. Throat swab and blood sample were taking from each student. One hundred and four (12.8%) healthy students were found to be Streptococcus pyogenes carriers. Pharyngeal Streptococcus pyogenes carriage rate was statistically insignificant among different age groups. However, it was found to be more common among females (66, 15%) than males (38, 10%) with statistically significant difference (χ2 = 4.52, P = 0.04). This study showed a high asymptomatic carriage rate of Streptococcus pyogenes in the throat of healthy school children in Sana'a city, Yemen.
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Affiliation(s)
- Arwa Mohammed Othman
- Microbiology and Immunology Department, Faculty of Medicine and Health Sciences, Sana'a University, Sanaa, Yemen.
| | - Rowa Mohammed Assayaghi
- Microbiology and Immunology Department, Faculty of Medicine and Health Sciences, Sana'a University, Sanaa, Yemen
| | - Huda Zaid Al-Shami
- Microbiology and Immunology Department, Faculty of Medicine and Health Sciences, Sana'a University, Sanaa, Yemen
| | - Riyadh Saif-Ali
- Biochemistry Department, Faculty of Medicine and Health Sciences, Sanaa University, Sanaa, Yemen
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Enhanced engineered ZnO nanostructures and their antibacterial activity against urinary, gastrointestinal, respiratory and dermal genital infections. APPLIED NANOSCIENCE 2019. [DOI: 10.1007/s13204-019-00996-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Muthanna A, Salim HS, Hamat RA, Shamsuddin NH, Zakariah SZ. Clinical Screening Tools to Diagnose Group A Streptococcal Pharyngotonsillitis in Primary Care Clinics to Improve Prescribing Habits. Malays J Med Sci 2018; 25:6-21. [PMID: 30914875 PMCID: PMC6422577 DOI: 10.21315/mjms2018.25.6.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Accepted: 07/30/2018] [Indexed: 12/02/2022] Open
Abstract
This review highlights the clinical scoring tools used for the management of acute pharyngotonsillitis in primary care clinics. It will include the prevalence of group A pharyngotonsillitis among children and adults worldwide and the selective tests employed for diagnosing group A streptococcal pharyngotonsillitis. Pharyngotonsillitis is one of the common reasons for visits to primary care clinics worldwide, and physicians tend to prescribe antibiotics according to the clinical symptoms, which leads to overprescribing antibiotics. This in turn may lead to serious health impacts and severe reactions and may promote antibiotic resistance. These significantly add on to the health care costs. The available information from health organisations and previous studies has indicated the need to manage the diagnosis of pharyngotonsillitis to improve prescribing habits in primary care clinics.
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Affiliation(s)
- Abdulrahman Muthanna
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia
| | - Hani Syahida Salim
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia
| | - Rukman Awang Hamat
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia
| | - Nurainul Hana Shamsuddin
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia
| | - Siti Zulaikha Zakariah
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia
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Turner AG, Ong CLY, Walker MJ, Djoko KY, McEwan AG. Transition Metal Homeostasis in Streptococcus pyogenes and Streptococcus pneumoniae. Adv Microb Physiol 2017; 70:123-191. [PMID: 28528647 DOI: 10.1016/bs.ampbs.2017.01.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Trace metals such as Fe, Mn, Zn and Cu are essential for various biological functions including proper innate immune function. The host immune system has complicated and coordinated mechanisms in place to either starve and/or overload invading pathogens with various metals to combat the infection. Here, we discuss the roles of Fe, Mn and Zn in terms of nutritional immunity, and also the roles of Cu and Zn in metal overload in relation to the physiology and pathogenesis of two human streptococcal species, Streptococcus pneumoniae and Streptococcus pyogenes. S. pneumoniae is a major human pathogen that is carried asymptomatically in the nasopharynx by up to 70% of the population; however, transition to internal sites can cause a range of diseases such as pneumonia, otitis media, meningitis and bacteraemia. S. pyogenes is a human pathogen responsible for diseases ranging from pharyngitis and impetigo, to severe invasive infections. Both species have overlapping capacity with respect to metal acquisition, export and regulation and how metal homeostasis relates to their virulence and ability to invade and survive within the host. It is becoming more apparent that metals have an important role to play in the control of infection, and with further investigations, it could lead to the potential use of metals in novel antimicrobial therapies.
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Affiliation(s)
- Andrew G Turner
- School of Chemistry and Molecular Biosciences and Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, QLD, Australia
| | - Cheryl-Lynn Y Ong
- School of Chemistry and Molecular Biosciences and Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, QLD, Australia
| | - Mark J Walker
- School of Chemistry and Molecular Biosciences and Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, QLD, Australia
| | - Karrera Y Djoko
- School of Chemistry and Molecular Biosciences and Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, QLD, Australia
| | - Alastair G McEwan
- School of Chemistry and Molecular Biosciences and Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, QLD, Australia.
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Ray D, Saha S, Sinha S, Pal NK, Bhattacharya B. Molecular characterization and evaluation of the emerging antibiotic-resistant Streptococcus pyogenes from eastern India. BMC Infect Dis 2016; 16:753. [PMID: 27955635 PMCID: PMC5153692 DOI: 10.1186/s12879-016-2079-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Accepted: 11/29/2016] [Indexed: 11/18/2022] Open
Abstract
Background Group A Streptococcus strains causing wide variety of diseases, recently became noticeable in eastern India, are not amenable to standard treatment protocol thus enhancing the possibility of disease morbidity by becoming antibiotic resistance. Methods The association of Lancefield group A Streptococcal variation with degree of vir architectural diversity was evaluated using emm typing and restriction fragment length polymorphism analyses. The antibiotic sensitivity patterns were examined by modified Kirby-Bauer method of disk diffusion. Percentage calculations, 95% confidence interval and one-way ANOVA were used to assess differences in proportions. Results Our observations revealed 20 different emm types and 13 different HaeIII vir typing patterns. A 1.2 kb fragment was found in all HaeIII typing pattern. Fragments of 1.2 kb and 550 bp were conserved in majority of the isolates. HinfI digestion was found proficient in differentiating the strains of same vir typing patterns. Strong predominance of speC (85%) and speF (80%) genes have been observed encoding exotoxins production. 4 isolates were found to be erythromycin resistant and were of genotype emm49. High degree of tetracycline resistance was shown by 53.57% isolates which belonged to 12 different emm genotypes. Conclusions These findings suggested that in addition to emm typing, sequential application of HaeIII and HinfI restriction enzymes in vir typing analysis is an effective tool for group A streptococcal molecular characterization associated with antibiotic resistance. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-2079-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Dipanwita Ray
- Biochemistry Research Wing, Department of Biochemistry, Dr. B C Roy Post Graduate Institute of Basic Medical Education and Research (IPGME&R), 244B, A J C Bose Road, Kolkata, 700020, India.
| | - Somnath Saha
- Nil Ratan Sarkar Medical College and Hospital, Kolkata, India
| | - Sukanta Sinha
- The West Bengal University of Health Sciences, Kolkata, India
| | | | - Basudev Bhattacharya
- Biochemistry Research Wing, Department of Biochemistry, Dr. B C Roy Post Graduate Institute of Basic Medical Education and Research (IPGME&R), 244B, A J C Bose Road, Kolkata, 700020, India. .,Health and Family Welfare Department, Directorate of Medical Education, Government of Tripura, 799001, Agartala, Tripura, India.
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Chang JC, Jimenez JC, Federle MJ. Induction of a quorum sensing pathway by environmental signals enhances group A streptococcal resistance to lysozyme. Mol Microbiol 2015; 97:1097-113. [PMID: 26062094 DOI: 10.1111/mmi.13088] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2015] [Indexed: 01/29/2023]
Abstract
The human-restricted pathogen Streptococcus pyogenes (Group A Streptococcus, GAS) is responsible for wide-ranging pathologies at numerous sites in the body but has the proclivity to proliferate in individuals asymptomatically. The ability to survive in diverse tissues is undoubtedly benefited by sensory pathways that recognize environmental cues corresponding to stress and nutrient availability and thereby trigger adaptive responses. We investigated the impact that environmental signals contribute to cell-to-cell chemical communication [quorum sensing (QS)] by monitoring activity of the Rgg2/Rgg3 and SHP-pheromone system in GAS. We identified metal limitation and the alternate carbon source mannose as two environmental indicators likely to be encountered by GAS in the host that significantly induced the Rgg-SHP system. Disruption of the metal regulator MtsR partially accounted for the response to metal depletion, whereas ptsABCD was primarily responsible for QS induction due to mannose, but each sensory system induced Rgg-SHP signaling apparently by different mechanisms. Significantly, we found that induction of QS, regardless of the GAS serotype tested, led to enhanced resistance to the antimicrobial agent lysozyme. These results indicate the benefits for GAS to integrate environmental signals with intercellular communication pathways in protection from host defenses.
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Affiliation(s)
- Jennifer C Chang
- Department of Medicinal Chemistry and Pharmacognosy, Center for Pharmaceutical Biotechnology, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, 60607, USA
| | - Juan Cristobal Jimenez
- Department of Microbiology and Immunology, College of Medicine, University of Illinois at Chicago, Chicago, IL, 60607, USA
| | - Michael J Federle
- Department of Medicinal Chemistry and Pharmacognosy, Center for Pharmaceutical Biotechnology, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, 60607, USA
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Mengeloglu FZ, Aktas E, Otlu B, Cömert F, Külah C, Tas E, Sümbüloglu V. Evaluation of emm gene types, toxin gene profiles and clonal relatedness of group A streptococci. Bosn J Basic Med Sci 2014; 13:163-9. [PMID: 23988167 DOI: 10.17305/bjbms.2013.2356] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of this study is to evaluate antibiotic susceptibilities, emm gene types, toxin gene profiles and clonal relatedness of group A streptococci (GAS) isolates obtained from patients and carriers. A total of 79 clinical isolates from patients and 60 isolates from carriers were included in the study. Emm typing, toxin gene detection for speA, speB, speC, speG and smeZ genes and pulsed-field gel electrophoresis (PFGE) was performed. Twenty-one distinct emm types were detected; the most common types were emm12, emm89, emm1, emm77, emm4 and emm3. The detection rates of both emm types and the toxin genes didn't differ significantly between patients and carriers. The presence of speA and smeZ was significantly higher in emm1 and speG was significantly lower in emm4 when compared to the other emm types. The rate of clustering obtained with PFGE wasn't significantly different in patients and carriers. As a result, twelve of the 21 emm types detected in this study were covered by the 26-valent vaccine, constituting 77.7% of the emm typeable isolates; however the emm4 type which is one of the most common types in the present study is not among this coverage.
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Affiliation(s)
- Firat Zafer Mengeloglu
- Department of Medical Microbiology, Faculty of Medicine, Abant Izzet Baysal University, Gölköy, 14280 Bolu, Turkey.
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Marks LR, Mashburn-Warren L, Federle MJ, Hakansson AP. Streptococcus pyogenes biofilm growth in vitro and in vivo and its role in colonization, virulence, and genetic exchange. J Infect Dis 2014; 210:25-34. [PMID: 24465015 DOI: 10.1093/infdis/jiu058] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Group A streptococcus (GAS) commonly colonizes the oropharynx and nonintact skin. However, colonization has been little studied and the role of biofilm formation is unclear, as biofilm experiments to date have not been conducted under conditions that mimic the host environment. METHODS In this study we grew GAS biofilms on human keratinocytes under various environmental conditions and used this model to evaluate colonization, invasive disease and natural transformation. RESULTS GAS grown on epithelial cells, but not biofilms grown on abiotic surfaces, produced biofilms with characteristics similar to in vivo colonization. These biofilm bacteria showed a 100-fold higher bacterial burden of nasal-associated lymphoid tissue in mice than broth-grown bacteria, and were not virulent during septic infection, which was attributed in part to down-regulation of genes typically involved in localized and invasive disease. We also showed for the first time that GAS were naturally transformable when grown in biofilms and during colonization of NALT in vivo. CONCLUSIONS These findings provide novel model systems to study biofilm formation of GAS in vitro and in vivo, suggest an important role for biofilm formation during GAS colonization, and provide an explanation for the known genome diversity within the GAS population.
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Hraoui M, Boubaker IBB, Doloy A, Redjeb SB, Bouvet A. Molecular Mechanisms of Tetracycline and Macrolide Resistance andemmCharacterization ofStreptococcus pyogenesIsolates in Tunisia. Microb Drug Resist 2011; 17:377-82. [DOI: 10.1089/mdr.2010.0160] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Manel Hraoui
- Faculté de Médecine de Tunis, Laboratoire de Recherche “Résistance aux Antimicrobiens,” Tunis, Tunisia
| | | | - Alexandra Doloy
- Service de Microbiologie - Hygiène, Hôtel Dieu, Assistance Publique–Hôpitaux de Paris, Université Paris Descartes, Laboratoire associé au Centre National de Référence des Streptocoques pour les streptocoques du groupe A, Paris, France
| | - SaÏda Ben Redjeb
- Faculté de Médecine de Tunis, Laboratoire de Recherche “Résistance aux Antimicrobiens,” Tunis, Tunisia
| | - Anne Bouvet
- Service de Microbiologie - Hygiène, Hôtel Dieu, Assistance Publique–Hôpitaux de Paris, Université Paris Descartes, Laboratoire associé au Centre National de Référence des Streptocoques pour les streptocoques du groupe A, Paris, France
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Chang H, Shen X, Fu Z, Liu L, Shen Y, Liu X, Yu S, Yao K, Zhao C, Yang Y. Antibiotic resistance and molecular analysis of Streptococcus pyogenes isolated from healthy schoolchildren in China. ACTA ACUST UNITED AC 2010; 42:84-9. [PMID: 19883153 DOI: 10.3109/00365540903321598] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Streptococcus pyogenes are highly prevalent bacterial pathogens, especially in school-aged children. However, the characteristics of asymptomatic carriers vary geographically in different countries. We aimed to investigate S. pyogenes isolated from healthy schoolchildren in China. From 2007 to 2008, a total of 94 S. pyogenes isolates were obtained from healthy schoolchildren in Beijing and Chongqing, China. Antimicrobial susceptibility testing, determination of macrolide resistance genes (ermB, ermA and mefA), emm genotyping, pulsed-field gel electrophoresis (PFGE), and multilocus sequence typing (MLST) were performed. The resistance rate to macrolides was 96.8% and to tetracycline was 92.6%. All macrolide-resistant isolates exhibited constitutive resistance; 77 isolates (84.6%) had the ermB gene, while 14 isolates (15.4%) had the ermA gene. Among the macrolide-resistant isolates, the most frequent emm type was emm12 (51.6%), followed by emm22 (14.3%) and ST1815 (8.8%). PFGE analysis revealed 12 different patterns, with a given pattern having the same sequence type (ST) by MLST and the same emm type. In conclusion, the rate of macrolide resistance to S. pyogenes is currently very high in China. This is due primarily to the dissemination of a limited number of clones.
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Affiliation(s)
- Hesheng Chang
- Beijing Children's Hospital, Capital Medical University, 56 Nan Lishi Road, Beijing, China
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Generation of metabolically diverse strains of Streptococcus pyogenes during survival in stationary phase. J Bacteriol 2009; 191:6242-52. [PMID: 19666718 DOI: 10.1128/jb.00440-09] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Streptococcus pyogenes, in addition to causing fulminant disease, can be carried asymptomatically and may survive in the host without causing disease. Long-term stationary-phase cultures were used to characterize the metabolism of cultures surviving after glucose depletion. Survival of stationary-phase cultures in glucose-depleted rich medium was truncated by switching the cells to phosphate-buffered saline or by the addition of antibiotics, suggesting that survival depended on the presence of nutrients and metabolic activity. The metabolites of the pyruvate-to-acetate (PA) pathway (acetate and formate) and amino acid catabolic pathways (ammonia) accumulated throughout long-term stationary phase (12 weeks). Acid and ammonia production was balanced so that the culture pH was maintained above pH 5.6. Strains isolated from long-term stationary-phase cultures accumulated mutations that resulted in unique exponential-phase metabolisms, with some strains expressing the PA pathway, some strains producing ammonia, and some strains expressing both in the presence of glucose. Strains expressing high levels of PA pathway activity during exponential growth were unable to survive when regrown in pure culture due to the production of excess acid. These data suggest that S. pyogenes diversifies during survival in stationary phase into distinct strains with different metabolisms and that complementary metabolism is required to control the pH in stationary-phase cultures. One of three survivor strains isolated from tonsillar discard material from patients expressed high levels of the PA pathway during exponential growth. Sequencing of multiple group A streptococcus regulators revealed two different mutations in two different strains, suggesting that random mutation occurs during survival.
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Pires R, Rolo D, Gama-Norton L, Morais A, Lito L, Salgado MJ, Johansson C, Möllerberg G, Henriques-Normark B, Gonçalo-Marques J, Santos-Sanches I. Group A Streptococci from carriage and disease in Portugal: evolution of antimicrobial resistance and T antigenic types during 2000-2002. Microb Drug Resist 2006; 11:360-70. [PMID: 16359196 DOI: 10.1089/mdr.2005.11.360] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
In this study, we analyzed the antimicrobial resistance properties and T antigenic types of 511 isolates collected in Lisbon district, Portugal, from throat swabs of healthy subjects (n=341), during 2000-2002 and from diverse infection sites (n=170) of outpatients and inpatients, during 1999-2002. Erythromycin resistance was higher in tonsillitis/pharyngitis (27.4%) and skin infection isolates (21.1%), than in carriage and invasive isolates (<or=10%). Differences in erythromycin resistance among children and adults were noticed only for carriage isolates (9.3% in children and 21.1% in adults). Most erythromycin-resistant isolates from carriage (82.4%) and tonsillitis/pharyngitis (71.9%) showed the M phenotype. All M phenotype isolates (n=53) carried mef(A), whereas all MLS(B) phenotype isolates (n=19) carried erm(B) and not erm(A). Resistance to tetracycline [mediated by tet(M) in most isolates] was <or=6% in tonsillitis/pharyngitis and carriage isolates, 36.8% in skin infection isolates, and 44.1% in invasive isolates. The M phenotype increased since 2000, linked to a decrease of tetracycline resistance, and was predominantly associated with T1 in 2000-2001 and T12 in 2002 among carriage isolates, and with T8/25/Imp19 through 2000-2002 among tonsillitis/pharyngitis isolates. The majority (53%) of the tetracycline-resistant invasive isolates were nontypable. All isolates were susceptible to penicillin and chloramphenicol. This study showed that tetracycline and macrolide resistance frequency and phenotypes differ among GAS from various origins and changed over time. Moreover, T typing suggested that most drug-resistant isolates causing oropharyngeal carriage are distinct from the majority of isolates causing noninvasive and invasive infection.
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Affiliation(s)
- R Pires
- Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Monte de Caparica, Portugal
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Kuzucu C, Cizmeci Z, Durmaz R, Durmaz B, Ozerol IH. The Prevalence of Fecal Colonization of Enterococci, the Resistance of the Isolates to Ampicillin, Vancomycin, and High-Level Aminoglycosides, and the Clonal Relationship Among Isolates. Microb Drug Resist 2005; 11:159-64. [PMID: 15910231 DOI: 10.1089/mdr.2005.11.159] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
The gastrointestinal tract carriage of enterococci was searched in 150 hospitalized patients and 100 outpatients, and clonal relatedness of the isolates and their resistance to ampicillin, vancomycin, and high-level streptomycin and gentamicin were investigated. A stool sample or rectal swab collected from each patient was inoculated into appropriate media within an hour. Enterococcus species were identified by using conventional biochemical tests, API-20 Strep assay, and BBL crystal kit. Antibiotic susceptibility tests were performed using Kirby-Bauer disk diffusion method. A polymerase chain reaction (PCR) was used to detect vanA and vanB genes. Pulsed-field gel electrophoresis (PFGE) and arbitrarily primed-polymerase chain reaction (AP-PCR) methods were used for molecular typing of the strains. Enterococci were isolated from 90 (60%) of the specimens collected from 150 inpatients. Of these 90 isolates, 37 (41%) had high-level gentamicin resistance, 36 (40%) had high-level streptomycin resistance, and 50 (55.6%) had ampicillin resistance. Fecal colonization was found in 30% of the outpatients. Resistances to ampicillin, high-level streptomycin, and gentamicin were 13%, 10%, and 3%, in these patients' isolates, respectively. No vancomycin-resistant enterococci were detected by both agar diffusion and PCR assays in our study. Both typing procedures were applied on 78 Enterococcus strains isolated from inpatients. AP-PCR typing showed that 30 (50.8%) of the 59 E. faecium and 5 (50%) of the 10 E. faecalis strains were clonally related. These values were found to be 12 (20.3%) and two (20%) by PFGE, respectively. The typing procedures did not find any clustered strains in the six E. durans and three E. avium isolates. Neither PFGE nor AP-PCR result was significantly different among the sensitive and resistant strains. Our results indicate that the high prevalence of colonization with ampicillin and highlevel aminoglycoside-resistant enterococci is an important problem in our medical center. The high clonal diversity among the isolates indicates limited spread of antibiotic-resistant strains between patients.
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Affiliation(s)
- Cigdem Kuzucu
- Department of Clinical Microbiology, Inonu University, Malatya, Turkey
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