title: Contrasting molecular epidemiology of group A streptococci causing tropical and nontropical infections of the skin and throat.
abstract: Disease caused by group A streptococci (GAS) in tropical regions often takes the form of impetigo, whereas pharyngitis tends to predominate in temperate zones. GAS derived from asymptomatic throat infections and pyoderma lesions of rural Aboriginal Australians were evaluated for phylogenetic distant emm genes, which represent ecological markers for tissue site preference. On the basis of the percentage of total isolates from a given tissue, emm pattern A-C organisms exhibited a stronger predilection for the throat, whereas pattern D organisms preferred the skin. Only 16% of isolates collected by active surveillance displayed pattern A-C, which reflects the low incidence of oropharyngeal infection. Importantly, most (70%) pattern A-C organisms were isolated from skin sores, despite their innate tendency to infect the throat. Combined with findings from nontropical populations, analysis of the data supports the hypothesis that GAS tissue preferences are genetically predetermined and that host risk factors for infection strongly influence the differential reproduction of individual clones.
authors.affiliation: Yale University School of Medicine, Dept. of Epidemiology and Public Health, New Haven, CT 06520. debra.bessen@yale.edu
authors.forename: D E
authors.initials: DE
authors.lastname: Bessen
authors.forename: J R
authors.initials: JR
authors.lastname: Carapetis
authors.forename: B
authors.initials: B
authors.lastname: Beall
authors.forename: R
authors.initials: R
authors.lastname: Katz
authors.forename: M
authors.initials: M
authors.lastname: Hibble
authors.forename: B J
authors.initials: BJ
authors.lastname: Currie
authors.forename: T
authors.initials: T
authors.lastname: Collingridge
authors.forename: M W
authors.initials: MW
authors.lastname: Izzo
authors.forename: D A
authors.initials: DA
authors.lastname: Scaramuzzino
authors.forename: K S
authors.initials: KS
authors.lastname: Sriprakash
mesh_terms: D000328:Adult; D000942:Antigens, Bacterial; D001315:Australia / Q000453:epidemiology; D001425:Bacterial Outer Membrane Proteins; D001426:Bacterial Proteins / Q000235:genetics; D002352:Carrier Proteins / Q000235:genetics; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology; D002648:Child; D006801:Humans; D007169:Impetigo / Q000453:epidemiology / Q000382:microbiology; D017720:Molecular Epidemiology; D010612:Pharyngitis / Q000453:epidemiology* / Q000382:microbiology*; D010802:Phylogeny; D011711:Pyoderma / Q000453:epidemiology / Q000382:microbiology; D012424:Rural Population; D017192:Skin Diseases, Bacterial / Q000453:epidemiology*; D013290:Streptococcal Infections / Q000453:epidemiology*; D013297:Streptococcus pyogenes / Q000235:genetics* / Q000302:isolation & purification; D014329:Tropical Climate
chemical_list: D000942:Antigens, Bacterial; D001425:Bacterial Outer Membrane Proteins; D001426:Bacterial Proteins; D002352:Carrier Proteins; C014689:streptococcal M protein