title: Molecular epidemiology of group A streptococcus causing scarlet fever in northern Taiwan, 2001-2002.
abstract: In this study, 830 Streptococcus pyogenes isolates collected between 2001 and 2002 from patients with scarlet fever in northern Taiwan were analyzed by M protein gene (emm) sequence typing, pulsed-field gel electrophoresis (PFGE), and antimicrobial susceptibility testing. A total of 21 emm types and 56 PFGE patterns were identified. The most frequent emm types were emm1 (29.2%), emm4 (24.1%), emm12 (19.0%), emm6 (15.8%), stIL103 (5.7%), and emm22 (1.9%). Antimicrobial resistance profiles were determined, and resistance to erythromycin (24.6%), clindamycin (2.0%), and chloramphenicol (1.3%) was detected. Five major emm types (emm4, emm12, emm1, emm22, and emm6) accounted for 95.6% of the erythromycin-resistant isolates. The decreased prevalence of erythromycin-resistant emm12 strains coincided with the overall decrease in erythromycin resistance from 32.1% in 2001 to 21.1% in 2002 in Taiwan. Five major clones (emm4/2000, emm12/0000, emm4/2010, emm1/1000, and emm22/8100) represented 72.1% of the erythromycin-resistant isolates. The survey of group A Streptococcus emm types, genetic diversity, and antibiotic resistance has direct relevance to current antimicrobial use policies and potential vaccine development strategies.
authors.affiliation: Research and Diagnostics Center, Centers for Disease Control, Taipei, Taiwan.
authors.forename: Ying-Yan
authors.initials: YY
authors.lastname: Chen
authors.forename: Chung-Ter
authors.initials: CT
authors.lastname: Huang
authors.forename: Shu-Man
authors.initials: SM
authors.lastname: Yao
authors.forename: Yi-Ching
authors.initials: YC
authors.lastname: Chang
authors.forename: Pei-Wun
authors.initials: PW
authors.lastname: Shen
authors.forename: Chen-Ying
authors.initials: CY
authors.lastname: Chou
authors.forename: Shu-Ying
authors.initials: SY
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D000942:Antigens, Bacterial / Q000235:genetics; D001425:Bacterial Outer Membrane Proteins / Q000235:genetics; D002352:Carrier Proteins / Q000235:genetics; D002648:Child; D002675:Child, Preschool; D002701:Chloramphenicol / Q000494:pharmacology; D002981:Clindamycin / Q000494:pharmacology; D016000:Cluster Analysis; D016172:DNA Fingerprinting; D004269:DNA, Bacterial / Q000235:genetics; D024881:Drug Resistance, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D004917:Erythromycin / Q000494:pharmacology; D006801:Humans; D007223:Infant; D008826:Microbial Sensitivity Tests; D017720:Molecular Epidemiology; D012541:Scarlet Fever / Q000453:epidemiology* / Q000382:microbiology*; D017422:Sequence Analysis, DNA; D013291:Streptococcus; D013297:Streptococcus pyogenes / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D013624:Taiwan / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D000942:Antigens, Bacterial; D001425:Bacterial Outer Membrane Proteins; D002352:Carrier Proteins; D004269:DNA, Bacterial; C014689:streptococcal M protein; D002981:Clindamycin; D004917:Erythromycin; D002701:Chloramphenicol