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Description of macrolide-resistant and potential virulent clones of Streptococcus pyogenes causing asymptomatic colonization during 2000–2006 in the Lisbon area

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Abstract

The asymptomatic oropharyngeal colonization rate by Streptococcus pyogenes was 10.7% in children (901 among 8,405 children 0–16 years old) and 3.3% in adults (37 among 1,126 households of children) in the Lisbon area during 2000–2006. Macrolide-resistant S. pyogenes from children (n = 149) was variable with time: 9.8–10.7% in 2000–2002, 28.1% in 2003, 19.6–2.7% in 2004–2005 and 14.6% in 2006. Eight lineages (97.3% of isolates) were identified based on at least 80% similarity of PFGE patterns, T types, emm types and multilocus sequence types (ST). The elevated frequency of macrolide resistance was associated with M phenotype lineages I (emm12/ST36) and V (emm4, emm75/ST39 and a novel emmstMrp6 type) and with one cMLSB lineage IV (emm28/ST52) known to be associated with upper respiratory tract and invasive infections. Significant associations (p < 0.05) between emm type/virulence genotype were found, such as emm1/speA + ssa -, emm4/ssa + prtF1 +, emm12/speA - ssa -. The high prevalence (>20%) of speC, prtF1 or ssa was probably caused either by clonal dissemination (speC), or to horizontal gene transfer events (prtF1 and ssa). This report contributes to a better understanding of the molecular epidemiology and evolution of macrolide-resistant S. pyogenes causing symptom-free oropharyngeal colonization. These colonizing strains carry macrolide resistance and virulence genes capable of being transferred to other bacterial species sharing the same niche.

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Acknowledgements

This work was supported by Projects ref. POCTI/ESP/41971/2001 and POCTI/ESP/48407/2002 from Fundação para a Ciência e a Tecnologia (FCT), Portugal, and FEDER, awarded to Ilda Santos-Sanches, and Project ref. 212/1999 from Ministério da Saúde, Portugal, awarded to José Gonçalo-Marques. Dora Rolo was recipient of Grant BI 48407/2002 (2004–2006) and Renato Pires was recipient of Grants BI 41971/2001 (2002–2004) and SFRH/BD/32374/2006 (2007–2010), all from FCT, Portugal. None of the authors has any potential conflicts of interest.

The authors would like to thank Patrícia Broeiro, Paula Correia, and Carla Pereira (Centro de Saúde do Lumiar, Lisboa); Luísa Romeiro, Fátima Vaz, Teresa Ramos, Clotilde Gameiro, Filomena Andrade, Ana Lopes, Joana Queiroga, and Inês Dias (Centro de Saúde de Oeiras, Oeiras) for their participation in the collection of isolates from carriers. The authors are also grateful to Gian Maria Rossolini and Stefania Cresti (University of Siena, Italy); Birgitta Henriques-Normark (Swedish Institute for Infectious Disease Control, Solna, Sweden); Malak Kotb (University of Tennessee, Memphis, USA), and Gursharan Singh Chhatwal (German National Research Centre for Biotechnology, Braunschweig, Germany) for providing the control isolates for PCR assays. We also thank Lélia Chambel, Rogério Tenreiro, Sandra Chaves, and Tânia Tenreiro, from the Instituto de Ciência Aplicada e Tecnologia (ICAT) for guidance with BioNumerics software. We also thank Gabriela Ribeiro (Grant BIC 41971/2001 [2001–2002] from FCT, Portugal), Leonor Gama-Norton, Rita Cabral, Ana Margarida Sousa, Cláudia Marques, Sónia Custódio, Alexandra Nunes, Luís Sobreira, Sónia Cândido, Débora Tavares, Inês Faustino, and Maria João Santos for partial characterization of the isolates, and to Ingrid Andersson for excellent technical assistance. We acknowledge the use of the Streptococcus pyogenes MLST database, which is located at Imperial College London and is funded by the Wellcome Trust.

This study was presented in part, as a poster presentation (Abstr. P755) at the 25th International Congress of Chemotherapy (ICC)/17th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID; Munich, Germany, 31 March 31 to 3 April 2007).

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  1. D. Rolo

    Present address: Microbiology Department, Institut d’Investigació Biomèdica de Bellvitge, Hospital Universitari de Bellvitge, Barcelona, Spain

Authors and Affiliations

  1. Centro de Recursos Microbiológicos, Departamento de Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Campus de Caparica, 2829-516, Caparica, Portugal

    R. Pires, D. Rolo & I. Santos-Sanches

  2. Centro de Saúde de Oeiras, Oeiras, Portugal

    A. Morais & A. Brito-Avô

  3. Swedish Institute for Infectious Disease Control, Solna, Sweden

    C. Johansson & B. Henriques-Normark

  4. Hospital de Santa Maria, Lisbon, Portugal

    J. Gonçalo-Marques

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Pires, R., Rolo, D., Morais, A. et al. Description of macrolide-resistant and potential virulent clones of Streptococcus pyogenes causing asymptomatic colonization during 2000–2006 in the Lisbon area. Eur J Clin Microbiol Infect Dis 31, 849–857 (2012). https://doi.org/10.1007/s10096-011-1384-x

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