Group A streptococcal pharyngitis serotype surveillance in North America, 2000-2002.
Geographic and interseasonal heterogeneity of pharyngeal group A streptococcal (GAS) genotypes (emm types) is poorly characterized. We evaluated emm type and subtype distribution among pediatric pharyngitis isolates obtained from 9 sites in the United States during 2000-2001 (year 1) and from 10 sites in the United States and 1 site in Canada during 2001-2002 (year 2). The 7 predominant types were the same in both years, although their order changed. emm 12, 1, and 28 accounted for 49.2% of year 1 isolates, and emm 1, 12, and 4 accounted for 47.1% of year 2 isolates; 6 types accounted for 72.1% in year 1 and 69.4% in year 2. From year 1 to year 2, the proportions of emm 12 and 28 decreased and emm 1 and 6 increased. Striking intersite and interseasonal variations in the distribution of predominant emm types were observed. We conclude that the most-predominant GAS genotypes were similar for each year despite fluctuations, that intersite and intrasite variations in the distribution of emm types were apparent, and that emm type surveillance is needed as M protein vaccine development proceeds.
Division of Infectious Diseases, Children's Memorial Hospital, Chicago, IL, USA. sshulman@northwestern.edu
Stanford T
ST
Shulman
Robert R
RR
Tanz
William
W
Kabat
Kathleen
K
Kabat
Emily
E
Cederlund
Devendra
D
Patel
Zhongya
Z
Li
Varja
V
Sakota
James B
JB
Dale
Bernard
B
Beall
D000293:Adolescent; D000595:Amino Acid Sequence; D000942:Antigens, Bacterial / Q000235:genetics / Q000276:immunology; D001425:Bacterial Outer Membrane Proteins / Q000235:genetics / Q000276:immunology; D001483:Base Sequence; D002170:Canada / Q000453:epidemiology; D002352:Carrier Proteins / Q000235:genetics / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008969:Molecular Sequence Data; D010612:Pharyngitis / Q000382:microbiology*; D011159:Population Surveillance; D015995:Prevalence; D012703:Serotyping; D013290:Streptococcal Infections / Q000453:epidemiology / Q000382:microbiology*; D013297:Streptococcus pyogenes / Q000145:classification / Q000235:genetics / Q000276:immunology; D014481:United States / Q000453:epidemiology
D000942:Antigens, Bacterial; D001425:Bacterial Outer Membrane Proteins; D002352:Carrier Proteins; C014689:streptococcal M protein