title: High-resolution genotyping elucidates the epidemiology of group A streptococcus outbreaks.
abstract: Streptococcus pyogenes strains were genotyped by a combination of molecular methods for high- resolution epidemiologic studies of disease outbreaks. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis of the emm gene is reported. Alone or in conjunction with other molecular techniques (16S ribotyping, pulsed-field gel electrophoresis, and detection of exotoxin genes), PCR-RFLP could differentiate outbreak-related strains from contemporaneous background strains of the same M serotype. Three outbreaks were studied: pharyngitis in a boarding school (serotype M5), cross-infection in a hospital burn unit (serotype M76), and severe invasive disease in two elderly care homes (serotype R28). It was possible, for example, to identify within serotype R28 a clone with particular potential for invasive disease. In all cases, the four molecular methods yielded complementary results that were hierarchically related. Strains could be assigned to the outbreak or the background in a precise, reproducible, and rapid manner.
authors.affiliation: Virus Reference Division, Central Public Health Laboratory, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Stanley
authors.forename: M
authors.initials: M
authors.lastname: Desai
authors.forename: J
authors.initials: J
authors.lastname: Xerry
authors.forename: A
authors.initials: A
authors.lastname: Tanna
authors.forename: A
authors.initials: A
authors.lastname: Efstratiou
authors.forename: R
authors.initials: R
authors.lastname: George
mesh_terms: D000942:Antigens, Bacterial; D001425:Bacterial Outer Membrane Proteins; D001426:Bacterial Proteins / Q000276:immunology; D001483:Base Sequence; D002053:Burn Units; D002352:Carrier Proteins; D003428:Cross Infection / Q000382:microbiology; D004196:Disease Outbreaks; D004739:England; D005819:Genetic Markers; D005838:Genotype; D006801:Humans; D008969:Molecular Sequence Data; D009735:Nursing Homes; D016133:Polymerase Chain Reaction; D012150:Polymorphism, Restriction Fragment Length; D015183:Restriction Mapping; D012574:Schools; D012703:Serotyping; D013290:Streptococcal Infections / Q000453:epidemiology* / Q000235:genetics*; D013297:Streptococcus pyogenes / Q000235:genetics* / Q000276:immunology
chemical_list: D000942:Antigens, Bacterial; D001425:Bacterial Outer Membrane Proteins; D001426:Bacterial Proteins; D002352:Carrier Proteins; D005819:Genetic Markers; C014689:streptococcal M protein