title: emm and C-repeat region molecular typing of beta-hemolytic Streptococci in a tropical country: implications for vaccine development.
abstract: We designed a study to investigate the molecular epidemiology of group A streptococcal (GAS) and group C and G streptococcal (GCS and GGS) disease in Fiji, a country which is known to have a high burden of streptococcal disease. Molecular typing of the N-terminal portion (emm typing) of the M protein was performed with 817 isolates (535 GAS and 282 GCS/GGS). We also performed genotyping of the C-repeat region in 769 of these isolates to identify J14 sequence types. The profile of emm types for Fiji was very different from that found for the United States and Europe. There were no dominant emm types and a large number of overlapping types among clinical disease states. Commonly found GAS emm types in industrialized countries, including emm1, emm12, and emm28, were not found among GAS isolates from Fiji. Over 93% of GAS isolates and over 99% of GCS/GGS isolates that underwent J14 sequence typing contained either J14.0 or J14.1. Our data have implications for GAS vaccine development in developing countries and suggest that a vaccine based upon the conserved region of the M protein may be a feasible option for Fiji and potentially for other tropical developing countries.
authors.affiliation: Centre for International Child Health, Department of Paediatrics, University of Melbourne, Victoria, Australia. andrew.steer@rch.org.au
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Steer
authors.forename: Graham
authors.initials: G
authors.lastname: Magor
authors.forename: Adam W J
authors.initials: AW
authors.lastname: Jenney
authors.forename: Joseph
authors.initials: J
authors.lastname: Kado
authors.forename: Michael F
authors.initials: MF
authors.lastname: Good
authors.forename: David
authors.initials: D
authors.lastname: McMillan
authors.forename: Michael
authors.initials: M
authors.lastname: Batzloff
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Carapetis
mesh_terms: D000293:Adolescent; D000942:Antigens, Bacterial / Q000235:genetics*; D001425:Bacterial Outer Membrane Proteins / Q000235:genetics*; D015373:Bacterial Typing Techniques; D002352:Carrier Proteins / Q000235:genetics*; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D016172:DNA Fingerprinting / Q000379:methods*; D004269:DNA, Bacterial / Q000235:genetics*; D005367:Fiji / Q000453:epidemiology; D014644:Genetic Variation; D005838:Genotype; D006801:Humans; D017720:Molecular Epidemiology; D013290:Streptococcal Infections / Q000453:epidemiology* / Q000382:microbiology*; D022541:Streptococcal Vaccines / Q000276:immunology; D013291:Streptococcus / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification
chemical_list: D000942:Antigens, Bacterial; D001425:Bacterial Outer Membrane Proteins; D002352:Carrier Proteins; D004269:DNA, Bacterial; D022541:Streptococcal Vaccines; C014689:streptococcal M protein