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Molecular characterisation of invasive Streptococcus pyogenes isolates from Hungary obtained in 2004 and 2005

  • B. KrucsóEmail author
  • M. Gacs
  • B. Libisch
  • Zs. Vargáné Hunyadi
  • K. Molnár
  • M. Füzi
  • J. Pászti
Concise Article

Abstract

Our aim was to characterise by molecular techniques group A streptococci isolated from invasive infections in Hungary in 2004–2005. Twenty-six nonduplicate invasive GAS isolates were selected and examined. The mortality rate proved high (52.3%) for those cases (n = 21) where data were available. Predominant emm types were emm1 (n = 13, 50%) and emm80 (n = 5, 19.2%), but other M types (emm4, emm28, emm66, emm81.1, emm82, emm84) were also identified. Eight different PFGE types were distinguished, and each emm type showed an individual PFGE pattern. Our results show that—similarly to results obtained in several other countries—emm type 1 strains predominate among invasive GAS isolates, and that emm 1 type strains recovered from severe streptococcal infections were associated with the presence of the speA gene. The rate for macrolide resistance proved low: only two isolates showed elevated MICs for erythromycin.

Keywords

Necrotizing Fasciitis Toxic Shock Syndrome Scarlet Fever PFGE Pattern Streptococcal Disease 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Abbreviations

GAS

group A streptococcus

TSS

toxic shock syndrome

PFGE

pulsed-field gel electrophoresis

NCE

National Center for Epidemiology

CLSI

Clinical and Laboratory Standards Institute

CDC

Centres for Disease Control and Prevention

IUD

intrauterine device

PYR

pyrrolidonyl arylamidase

References

  1. 1.
    Fischetti VA (1989) Streptococcal M protein: molecules design and biological behavior. Clin Microbiol Rev 2:285–314PubMedGoogle Scholar
  2. 2.
    Szita J, Káli M (1970) Type distribution of Streptococcus pyogenes in the years 1964–65 and 1968–69. Acta Microbiol Acad Sci Hung 17:347–356PubMedGoogle Scholar
  3. 3.
    Yu CE, Ferretti JJ (1989) Molecular epidemiologic analysis of the type A streptococcal exotoxin (erythrogenic toxin) gene (speA) in clinical Streptococcus pyogenes strains. Infect Immun 57:3715–3719PubMedGoogle Scholar
  4. 4.
    The Working Group on Severe Streptococcal Infections (1993) Defining the group A streptococcal toxic shock syndrome. Rationale and consensus definition. The Working Group on Severe Streptococcal Infections. JAMA 269:390–391CrossRefGoogle Scholar
  5. 5.
    CLSI (2005) Performance standards for antimicrobial susceptibility testing (M100-S-15); Fifteenth Informational Supplement. Clinical and Laboratory Standards Institute, West Valley Road, Suite 1400, Wayne, Pennsylvania USAGoogle Scholar
  6. 6.
    Whatmore AM, Kehoe MA (1994) Horizontal gene transfer in the evolution of group A streptococcal emm like genes: gene mosaics and variation in Vir regulons. Mol Microbiol 11:363–374PubMedCrossRefGoogle Scholar
  7. 7.
    Facklam RF, Martin DR, Lovgren M, Johnson DR, Efstratiou A, Thompson TA, Gowan S, Kriz P, Tyrrell GJ, Kaplan E, Beall B (2002) Extension of the Lancefield classification for group A streptococci by addition of 22 new M protein gene sequence types from clinical isolates: emm103 to emm124. Clin Infect Dis 34:28–38PubMedCrossRefGoogle Scholar
  8. 8.
    Vlaminckx BJM, Mascini EM, Schellekens J, Schouls LM, Paauw A, Fluit Ad C, Novak R, Verhoef J, Schmitz FJ (2003) Site-specific manifestations of invasive group A streptococcal disease: type distribution and corresponding patterns of virulence determinants. J Clin Microbiol 41:4941–4949PubMedCrossRefGoogle Scholar
  9. 9.
    Goering RV, Winters MA (1992) Rapid method for epidemiological evaluation of gram-positive cocci by field inversion gel electrophoresis. J Clin Microbiol 30:577–580PubMedGoogle Scholar
  10. 10.
    Ekelund K, Skinhøj P, Madsen J, Konradsen HB (2005) Reemergence of emm1 and a changed superantigen profile for group A streptococci causing invasive infections:results from a nationwide study. J Clin Microbiol 43:1789–1796PubMedCrossRefGoogle Scholar
  11. 11.
    Cunningham MW (2000) Pathogenesis of group A streptococcal infections. Clin Microbiol Rev 13:470–511PubMedCrossRefGoogle Scholar
  12. 12.
    Lamagni TL, Efstratiou A, Vuopio-Varkila J, Jasir A, Schalén C, Strep-EURO (2005) The epidemiology of severe Streptococcus pyogenes associated disease in Europe. Eurosurveillance 10:179–184PubMedGoogle Scholar
  13. 13.
    Jasir A and Schalén C on behalf of the Strep-EURO study group (2005) Strep-EURO: progress in analysis and research into severe streptococcal disease in Europe, 2003–2004. Eurosurveillance 10:E050203.3PubMedGoogle Scholar
  14. 14.
    Szczypa K, Sadowy E, Izdebski R, Strakova L, Hryniewicz W (2006) Group A streptococci from invasive disease episodes in Poland are remarkably divergent at the molecular level. J Clin Microbiol 44:3975–3979PubMedCrossRefGoogle Scholar
  15. 15.
    Schmitz FJ, Beyer A, Charpentier E, Normark BH, Schade M, Fluit C, Hafner D, Novak R (2003) Toxin-gene profile heterogeneity among endemic invasive European group A Streptococcal isolates. J Infect Dis 188:1578–1586PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • B. Krucsó
    • 1
    Email author
  • M. Gacs
    • 2
  • B. Libisch
    • 2
  • Zs. Vargáné Hunyadi
    • 1
  • K. Molnár
    • 3
  • M. Füzi
    • 2
  • J. Pászti
    • 1
  1. 1.Department of Phage Typing and Molecular EpidemiologyNational Center for EpidemiologyBudapestHungary
  2. 2.Department of BacteriologyNational Center for EpidemiologyBudapestHungary
  3. 3.Office of the Chief Medical OfficerBudapestHungary

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