title: M protein typing of Thai group A streptococcal isolates by PCR-Restriction fragment length polymorphism analysis.
abstract: BACKGROUND
  Group A streptococcal (GAS) infections can lead to the development of severe post-infectious sequelae, such as rheumatic fever (RF) and rheumatic heart disease (RHD). RF and RHD are a major health concern in developing countries, and in indigenous populations of developed nations. The majority of GAS isolates are M protein-nontypeable (MNT) by standard serotyping. However, GAS typing is a necessary tool in the epidemiologically analysis of GAS and provides useful information for vaccine development. Although DNA sequencing is the most conclusive method for M protein typing, this is not a feasible approach especially in developing countries. To overcome this problem, we have developed a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP)-based assay for molecular typing the M protein gene (emm) of GAS.
  
  
  RESULTS
  Using one pair of primers, 13 known GAS M types showed one to four bands of PCR products and after digestion with Alu I, they gave different RFLP patterns. Of 106 GAS isolates examined from the normal Thai population and from patients with GAS-associated complications including RHD, 95 isolates gave RFLP patterns that corresponded to the 13 known M types. Only 11 isolates gave RFLP patterns that differed from the 13 known M types. These were then analyzed by DNA sequencing and six additional M types were identified. In addition, we found that M93 GAS was the most common M type in the population studied, and is consistent with a previous study of Thai GAS isolates.
  
  
  CONCLUSIONS
  PCR-RFLP analysis has the potential for the rapid screening of different GAS M types and is therefore considerably advantageous as an alternative M typing approach in developing countries in which GAS is endemic.
authors.affiliation: Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. amm_aon@yahoo.com
authors.forename: Nonglak
authors.initials: N
authors.lastname: Yoonim
authors.forename: Colleen
authors.initials: C
authors.lastname: Olive
authors.forename: Chulabhorn
authors.initials: C
authors.lastname: Pruksachatkunakorn
authors.forename: Michael F
authors.initials: MF
authors.lastname: Good
authors.forename: Sumalee
authors.initials: S
authors.lastname: Pruksakorn
mesh_terms: D000942:Antigens, Bacterial / Q000302:isolation & purification*; D001425:Bacterial Outer Membrane Proteins / Q000302:isolation & purification*; D001483:Base Sequence; D002352:Carrier Proteins / Q000302:isolation & purification*; D017931:DNA Primers; D006801:Humans; D016133:Polymerase Chain Reaction / Q000379:methods; D012150:Polymorphism, Restriction Fragment Length; D013297:Streptococcus pyogenes / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification*; D013785:Thailand
chemical_list: D000942:Antigens, Bacterial; D001425:Bacterial Outer Membrane Proteins; D002352:Carrier Proteins; D017931:DNA Primers; C014689:streptococcal M protein