title: Molecular typing of Streptococcus pyogenes from remote Aboriginal communities where rheumatic fever is common and pyoderma is the predominant streptococcal infection.
abstract: Aboriginal Australians in remote communities have high rates of rheumatic heart disease (RHD); yet pharyngitis is reportedly rare whilst pyoderma is common. Some strains of group A streptococci (GAS) have preference for the throat and others for the skin depending on M protein type. A study in three remote communities provided 350 GAS isolates for emm sequence typing, 244 were also emm pattern typed. There was 100% correlation between emm sequence and pattern type. Patterns D and E (non-throat tropic) made up 71% of throat and 87% of skin isolates although patterns A-C (throat tropic) were more common in the throat than the skin (RR 2.3, 95% CI 1.4-3.8) whilst the opposite was found for pattern D (RR 2.2, 95% CI 1.7-3.0). Pattern E favoured the throat (RR 1.4, 95% CI 1.1-1.8). Where environmental factors predispose to skin infection, emm pattern types D and E prevail, whatever the recovery site.
authors.affiliation: Menzies School of Health Research, Casuarina, 0811, NT, Australia. malcolm.mcdonald@menzies.edu.au
authors.forename: M I
authors.initials: MI
authors.lastname: McDonald
authors.forename: R J
authors.initials: RJ
authors.lastname: Towers
authors.forename: P
authors.initials: P
authors.lastname: Fagan
authors.forename: J R
authors.initials: JR
authors.lastname: Carapetis
authors.forename: B J
authors.initials: BJ
authors.lastname: Currie
mesh_terms: D000942:Antigens, Bacterial / Q000235:genetics; D001315:Australia / Q000453:epidemiology; D001425:Bacterial Outer Membrane Proteins / Q000235:genetics; D015373:Bacterial Typing Techniques; D002352:Carrier Proteins / Q000235:genetics; D002648:Child; D004269:DNA, Bacterial / Q000235:genetics; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D010614:Pharynx / Q000382:microbiology; D011711:Pyoderma / Q000453:epidemiology* / Q000382:microbiology; D012213:Rheumatic Fever / Q000453:epidemiology* / Q000382:microbiology; D012424:Rural Population; D017422:Sequence Analysis, DNA; D012867:Skin / Q000382:microbiology; D013290:Streptococcal Infections / Q000453:epidemiology* / Q000382:microbiology*; D013297:Streptococcus pyogenes / Q000145:classification* / Q000302:isolation & purification
chemical_list: D000942:Antigens, Bacterial; D001425:Bacterial Outer Membrane Proteins; D002352:Carrier Proteins; D004269:DNA, Bacterial; C014689:streptococcal M protein