Korean J Clin Microbiol.  2011 Sep;14(3):85-90. 10.5145/KJCM.2011.14.3.85.

Multicenter Study of Molecular Epidemiology and Antibiotic Resistance of Group A Streptococci in 2008-2009 in Korea

Affiliations
  • 1Department of Laboratory Madicine, Seoul National University College of Medicine, Seoul, Korea.
  • 2Department of Laboratory Madicine, Gyeongsang National University School of Medicine, Jinju, Korea. sjkim8239@hanmail.net
  • 3Department of Laboratory Madicine, Hanyang University College of Medicine, Seoul, Korea.
  • 4Department of Laboratory Madicine, Hallym University College of Medicine, Chuncheon, Korea.
  • 5Department of Laboratory Madicine, Inje University College of Medicine, Busan, Korea.
  • 6Department of Laboratory Madicine, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 7Department of Laboratory Madicine, University of Ulsan College of Medicine, Ulsan, Korea.
  • 8Department of Laboratory Madicine, Wonkwang University Medical School, Iksan, Korea.
  • 9Department of Laboratory Madicine, Pusan National University School of Medicine, Yangsan, Korea.
  • 10Department of Laboratory Madicine, Jeju National University School of Medicine, Jeju, Korea.

Abstract

BACKGROUND
Group A Streptococcus (GAS) is responsible for a wide spectrum of human diseases. We investigated the distribution of emm types and antibiotic resistance rates of GAS from clinical specimens in several Korean medical centers.
METHODS
A total of 192 strains of GAS from throat, blood, and other specimens collected in Seoul, Busan, Ulsan, Iksan, and Jeju were studied in 2008-2009. The emm genotypes were identified using PCR and sequencing. Antimicrobial susceptibility testing was performed by disk diffusion method. Phenotypes of macrolide resistance were evaluated, and macrolide resistance genes were determined by PCR.
RESULTS
The emm89 (33.9%) was most frequently detected, followed by emm1 (12.5%), emm12 (8.3%), emm4 (7.8%), and emm75 (7.3%). The distribution of emm types did not show a close relation to the type of specimen and was different for each area. The resistance rates to erythromycin (ERY) and clindamycin (CLI) were 4.6% and 3.7%, respectively. Among the nine ERY-resistant strains, the rate of constitutive resistance was 88.9%, compared with 11.1% for the M phenotype. Five of the ERY-resistant strains were emm28.
CONCLUSION
This multicenter study reveals heterogenous emm genotypes by geographic area. Rates of resistance to ERY and CLI were low, and most of the ERY-resistant strains showed a constitutive macrolide-lincosamide-streptogramin B (cMLSB) phenotype.

Keyword

Group A streptococcus; Streptococcus pyogenes; emm gene; Erythromycin resistance

MeSH Terms

Clindamycin
Diffusion
Drug Resistance, Microbial
Erythromycin
Genotype
Humans
Korea
Molecular Epidemiology
Pharynx
Phenotype
Polymerase Chain Reaction
Streptococcus
Streptococcus pyogenes
Clindamycin
Erythromycin

Figure

  • Fig. 1. Frequency of emm genotypes in this study and study of acute pharyngitis in Jinju, 2009 [14].


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