title: Epidemiological analysis of group A streptococci recovered from patients in China.
abstract: Since the mid-1980s, there has been a resurgence of severe forms of invasive group A streptococcal (GAS) disease in many countries and regions. However, there has not been any systemic epidemiologic analysis of GAS disease reported in mainland China. To analyse the molecular epidemiology of GAS disease, 86 strains from patients in different regions of mainland China were collected. The collection sites included blood, pus, wounds, the epipharynx and other sites. A total of 21 different emm types were identified in the isolates. In both invasive and non-invasive isolates, M1 (29.1%) and M12 (23.3%) were the most prevalent types, a different distribution to M type distributions reported in other countries. Furthermore, minor emm gene sequence alterations were noted for six types. Several important GAS virulence factors were detected by PCR using specific primers. The speB and slo genes were detected in all isolates and were species specific. Four superantigen genes, speA, speC, smeZ and ssa, were found in 52% (45/86), 51% (44/86), 82% (71/86) and 23% (27/86) of isolates, respectively. M1 isolates harboured more speA (84%) and fewer speC genes (44%), while M12 isolates had fewer speA (35%) and more speC genes (100%). There was also an association between some virulence genes and isolation sites, perhaps due to the correlation between the emm type distribution and virulence gene occurrence. For two important virulence genes related to necrotizing fasciitis, the sil gene was only carried by 11 of 86 isolates, and no sil gene contained the start codon ATA. The sla gene rarely occurred in GAS isolates, only four of 86 GAS strains being positive, including two isolates obtained from blood. In antimicrobial susceptibility tests, the overall rate of drug resistance in GAS isolates was higher than reported rates in other countries, and the resistance rates to erythromycin, tetracycline and clindamycin were 91.8, 93.4 and 80%, respectively. This epidemiological study may help to understand the pathogenesis of GAS disease and aid in vaccine development.
authors.affiliation: State Key Laboratory of Pathogen and Biosecurity, The Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, no. 20 Dongda Street, Fengtai District, Beijing, 100071, People's Republic of China.
authors.forename: Hong-Bo
authors.initials: HB
authors.lastname: Jing
authors.affiliation: State Key Laboratory of Pathogen and Biosecurity, The Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, no. 20 Dongda Street, Fengtai District, Beijing, 100071, People's Republic of China.
authors.forename: Boa-An
authors.initials: BA
authors.lastname: Ning
authors.affiliation: State Key Laboratory of Pathogen and Biosecurity, The Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, no. 20 Dongda Street, Fengtai District, Beijing, 100071, People's Republic of China.
authors.forename: Huai-Jie
authors.initials: HJ
authors.lastname: Hao
authors.affiliation: State Key Laboratory of Pathogen and Biosecurity, The Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, no. 20 Dongda Street, Fengtai District, Beijing, 100071, People's Republic of China.
authors.forename: Yu-Ling
authors.initials: YL
authors.lastname: Zheng
authors.affiliation: 304 Hospital, Haidian District, Beijing, 100037, People's Republic of China.
authors.forename: Dong
authors.initials: D
authors.lastname: Chang
authors.affiliation: 304 Hospital, Haidian District, Beijing, 100037, People's Republic of China.
authors.forename: Wei
authors.initials: W
authors.lastname: Jiang
authors.affiliation: State Key Laboratory of Pathogen and Biosecurity, The Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, no. 20 Dongda Street, Fengtai District, Beijing, 100071, People's Republic of China.
authors.forename: Yong-Qiang
authors.initials: YQ
authors.lastname: Jiang
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics; D002681:China / Q000453:epidemiology; D005798:Genes, Bacterial / Q000235:genetics; D006801:Humans; D017720:Molecular Epidemiology; D013045:Species Specificity; D013290:Streptococcal Infections / Q000453:epidemiology*; D013297:Streptococcus pyogenes / Q000145:classification / Q000187:drug effects / Q000235:genetics*; D037521:Virulence Factors / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D037521:Virulence Factors