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Huang YC, Lai JF, Wu CJ, Huang IW, Kuo SC, Liao CL, Huang TW, Lauderdale TL. High-level levofloxacin-resistant emm12 group A Streptococcus, 2012-2018: A multicenter study in Taiwan. J Microbiol Immunol Infect 2023; 56:875-879. [PMID: 37188572 DOI: 10.1016/j.jmii.2023.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/16/2023] [Accepted: 04/20/2023] [Indexed: 05/17/2023]
Abstract
High-level levofloxacin-resistant group A Streptococcus emerged in Taiwan in 2012. Among the 24 isolates identified, 23 belonged to emm12/ST36, most harbored the same GyrA and ParC mutations and were highly clonal. wgMLST showed them to be closely related to the Hong Kong scarlet fever outbreak strains. Continuous surveillance is warranted.
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Affiliation(s)
- Ying-Chi Huang
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - Jui-Fen Lai
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - Chi-Jung Wu
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan; Department of Internal Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
| | - I-Wen Huang
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - Shu-Chen Kuo
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - Ching-Len Liao
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - Tzu-Wen Huang
- Department of Microbiology and Immunology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Tsai-Ling Lauderdale
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan.
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Cubria MB, Delgado J, Shah BJ, Sanson MA, Flores AR. Identification of epidemic scarlet fever group A Streptococcus strains in the paediatric population of Houston, TX, USA. Access Microbiol 2021; 3:000274. [PMID: 34816093 PMCID: PMC8604173 DOI: 10.1099/acmi.0.000274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 08/23/2021] [Indexed: 11/18/2022] Open
Abstract
Scarlet fever (SF) has recently been associated with group A streptococcal (GAS) strains possessing multidrug resistance and specific streptococcal exotoxins. We screened a local surveillance collection of GAS emm12 strains in Houston, TX, USA for antimicrobial resistance and identified a single isolate matching the antimicrobial resistance pattern previously reported for SF clones. Using whole-genome sequencing and combining genome sequence data derived from national surveillance databases, we identified additional emm12 GAS clones similar to those associated with prior SF outbreaks, emphasizing the need for continued surveillance for epidemic emergence in the USA.
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Affiliation(s)
- M Belen Cubria
- Division of Infectious Diseases, Department of Pediatrics, McGovern Medical School at the University of Texas Health Sciences Center at Houston, Houston, Texas, USA
| | - Jose Delgado
- Division of Infectious Diseases, Department of Pediatrics, McGovern Medical School at the University of Texas Health Sciences Center at Houston, Houston, Texas, USA
| | - Brittany J Shah
- Division of Infectious Diseases, Department of Pediatrics, McGovern Medical School at the University of Texas Health Sciences Center at Houston, Houston, Texas, USA
| | - Misu A Sanson
- Division of Infectious Diseases, Department of Pediatrics, McGovern Medical School at the University of Texas Health Sciences Center at Houston, Houston, Texas, USA
| | - Anthony R Flores
- Division of Infectious Diseases, Department of Pediatrics, McGovern Medical School at the University of Texas Health Sciences Center at Houston, Houston, Texas, USA.,Center for Antimicrobial Resistance and Microbial Genomics, McGovern Medical School at the University of Texas Health Sciences Center at Houston, Houston, Texas, USA
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Tsai WC, Shen CF, Lin YL, Shen FC, Tsai PJ, Wang SY, Lin YS, Wu JJ, Chi CY, Liu CC. Emergence of macrolide-resistant Streptococcus pyogenes emm12 in southern Taiwan from 2000 to 2019. J Microbiol Immunol Infect 2020; 54:1086-1093. [PMID: 32994137 DOI: 10.1016/j.jmii.2020.08.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 08/26/2020] [Accepted: 08/30/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Group A Streptococcus (GAS) is an important pathogen causing morbidity and mortality worldwide. Surveillance of resistance and emm type has important implication to provide helpful information on the changing GAS epidemiology and empirical treatment. METHODS To study the emergence of resistant GAS in children with upper respiratory tract infection (URTI), a retrospective study was conducted from 2000 to 2019 in southern Taiwan. Microbiological studies, including antibiotic susceptibility, were performed. GAS emm types and sequences were determined by molecular methods. The population was divided into two separate decades to analyze potential changes over time. The 1st decade was 2000-2009; the 2nd decade was 2010-2019. Multivariate analyses were performed to identify independent risk factors associated with macrolide resistance between these periods. RESULTS A total of 320 GAS from 339 children were enrolled. Most of the children (75%) were under 9 years of age. The most common diagnosis was scarlet fever (225, 66.4%), and the frequency increased from 54.8% in the 1st to 77.9% in the 2nd decade (p < 0.0001). There was a significant increase in resistance to erythromycin and azithromycin from 18.1%, 19.3% in the 1st to 58.4%, 61.0% in the 2nd decade (p < 0.0001). This was associated with clonal expansion of the GAS emm12-ST36 which carrying erm(B) and tet(M) from 3.0% in the 1st to 53.2% in the 2nd decade (p < 0.0001). CONCLUSIONS Significant emergence of macrolide-resistant GAS emm12-ST36 in children supports the need for continuing surveillance and investigation for the clonal virulence.
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Affiliation(s)
- Wei-Chun Tsai
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Ching-Fen Shen
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Ya-Lan Lin
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Fan-Ching Shen
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli County, Taiwan
| | - Pei-Jane Tsai
- Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan City, Taiwan; Center of Infectious Disease and Signaling Research, National Cheng Kung University, Tainan City, Taiwan
| | - Shu-Ying Wang
- Center of Infectious Disease and Signaling Research, National Cheng Kung University, Tainan City, Taiwan; Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Yee-Shin Lin
- Center of Infectious Disease and Signaling Research, National Cheng Kung University, Tainan City, Taiwan; Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Jiunn-Jong Wu
- Department of Biotechnology and Laboratory Science in Medicine, School of Biomedical Science and Engineering, National Yang Ming University, Taipei, Taiwan
| | - Chia-Yu Chi
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan; National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli County, Taiwan; Environmental and Occupational Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Ching-Chuan Liu
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan; Center of Infectious Disease and Signaling Research, National Cheng Kung University, Tainan City, Taiwan.
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