1887

Abstract

Since the mid-1980s, there has been a resurgence of severe forms of invasive group A streptococcal (GAS) disease in many countries and regions. However, there has not been any systemic epidemiologic analysis of GAS disease reported in mainland China. To analyse the molecular epidemiology of GAS disease, 86 strains from patients in different regions of mainland China were collected. The collection sites included blood, pus, wounds, the epipharynx and other sites. A total of 21 different types were identified in the isolates. In both invasive and non-invasive isolates, M1 (29.1 %) and M12 (23.3 %) were the most prevalent types, a different distribution to M type distributions reported in other countries. Furthermore, minor gene sequence alterations were noted for six types. Several important GAS virulence factors were detected by PCR using specific primers. The and genes were detected in all isolates and were species specific. Four superantigen genes, , , and , were found in 52 % (45/86), 51 % (44/86), 82 % (71/86) and 23 % (27/86) of isolates, respectively. M1 isolates harboured more (84 %) and fewer genes (44 %), while M12 isolates had fewer (35 %) and more genes (100 %). There was also an association between some virulence genes and isolation sites, perhaps due to the correlation between the type distribution and virulence gene occurrence. For two important virulence genes related to necrotizing fasciitis, the gene was only carried by 11 of 86 isolates, and no gene contained the start codon ATA. The gene rarely occurred in GAS isolates, only four of 86 GAS strains being positive, including two isolates obtained from blood. In antimicrobial susceptibility tests, the overall rate of drug resistance in GAS isolates was higher than reported rates in other countries, and the resistance rates to erythromycin, tetracycline and clindamycin were 91.8, 93.4 and 80 %, respectively. This epidemiological study may help to understand the pathogenesis of GAS disease and aid in vaccine development.

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2006-08-01
2019-10-13
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