title: Group A Streptococcus emm gene types in pharyngeal isolates, Ontario, Canada, 2002-2010.
abstract: Group A Streptococcus (GAS) is a human-adapted pathogen that causes a variety of diseases, including pharyngitis and invasive infections. GAS strains are categorized by variation in the nucleotide sequence of the gene (emm) that encodes the M protein. To identify the emm types of GAS strains causing pharyngitis in Ontario, Canada, we sequenced the hypervariable region of the emm gene in 4,635 pharyngeal GAS isolates collected during 2002-2010. The most prevalent emm types varied little from year to year. In contrast, fine-scale geographic analysis identified inter-site variability in the most common emm types. Additionally, we observed fluctuations in yearly frequency of emm3 strains from pharyngitis patients that coincided with peaks of emm3 invasive infections. We also discovered a striking increase in frequency of emm89 strains among isolates from patients with pharyngitis and invasive disease. These findings about the epidemiology of GAS are potentially useful for vaccine research.
authors.affiliation: The Methodist Hospital Research Institute, Houston, Texas 77030, USA.
authors.forename: Patrick R
authors.initials: PR
authors.lastname: Shea
authors.forename: Amy L
authors.initials: AL
authors.lastname: Ewbank
authors.forename: Javier H
authors.initials: JH
authors.lastname: Gonzalez-Lugo
authors.forename: Alexandro J
authors.initials: AJ
authors.lastname: Martagon-Rosado
authors.forename: Juan C
authors.initials: JC
authors.lastname: Martinez-Gutierrez
authors.forename: Hina A
authors.initials: HA
authors.lastname: Rehman
authors.forename: Monica
authors.initials: M
authors.lastname: Serrano-Gonzalez
authors.forename: Nahuel
authors.initials: N
authors.lastname: Fittipaldi
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Beres
authors.forename: Anthony R
authors.initials: AR
authors.lastname: Flores
authors.forename: Donald E
authors.initials: DE
authors.lastname: Low
authors.forename: Barbara M
authors.initials: BM
authors.lastname: Willey
authors.forename: James M
authors.initials: JM
authors.lastname: Musser
mesh_terms: D000483:Alleles; D000942:Antigens, Bacterial / Q000235:genetics*; D001425:Bacterial Outer Membrane Proteins / Q000235:genetics*; D002352:Carrier Proteins / Q000235:genetics*; D002648:Child; D002675:Child, Preschool; D005838:Genotype; D006801:Humans; D007223:Infant; D009864:Ontario / Q000453:epidemiology; D010612:Pharyngitis / Q000453:epidemiology* / Q000382:microbiology*; D010614:Pharynx / Q000382:microbiology; D058974:Phylogeography; D013290:Streptococcal Infections / Q000453:epidemiology*; D013297:Streptococcus pyogenes / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification
chemical_list: D000942:Antigens, Bacterial; D001425:Bacterial Outer Membrane Proteins; D002352:Carrier Proteins; C014689:streptococcal M protein
references.citation: J Immunol. 1996 Oct 1;157(7):3021-9
references.pmid: 8816411
references.citation: Clin Infect Dis. 2002 Feb 15;34(4):454-60
references.pmid: 11797171
references.citation: JAMA. 1997 Jan 1;277(1):38-43
references.pmid: 8980208
references.citation: Pediatrics. 2008 Feb;121(2):229-34
references.pmid: 18245412
references.citation: Proc Natl Acad Sci U S A. 1991 Apr 1;88(7):2668-72
references.pmid: 1672766
references.citation: Med Microbiol Immunol. 1994 Dec;183(6):299-306
references.pmid: 7596313
references.citation: J Immunol. 1998 Nov 1;161(9):4894-901
references.pmid: 9794423
references.citation: Proc Natl Acad Sci U S A. 1985 Mar;82(6):1822-6
references.pmid: 3885219
references.citation: Eur J Clin Microbiol Infect Dis. 2004 Jun;23(6):434-44
references.pmid: 15164257
references.citation: J Infect Dis. 1999 Dec;180(6):1921-8
references.pmid: 10558949
references.citation: Clin Infect Dis. 1993 Jun;16(6):792-800; discussion 801-2
references.pmid: 8329511
references.citation: Proc Natl Acad Sci U S A. 2010 Mar 2;107(9):4371-6
references.pmid: 20142485
references.citation: J Exp Med. 1919 Sep 1;30(3):179-213
references.pmid: 19868354
references.citation: Clin Infect Dis. 2009 Jul 1;49(1):78-84
references.pmid: 19480575
references.citation: Clin Infect Dis. 2007 Aug 15;45(4):450-8
references.pmid: 17638193
references.citation: J Clin Microbiol. 2003 Jan;41(1):373-8
references.pmid: 12517875
references.citation: Clin Infect Dis. 2005 Oct 15;41(8):1150-6
references.pmid: 16163634
references.citation: Clin Diagn Lab Immunol. 2005 Jul;12(7):833-6
references.pmid: 16002631
references.citation: Am J Med. 1997 Jul;103(1):18-24
references.pmid: 9236481
references.citation: Proc Natl Acad Sci U S A. 1981 Aug;78(8):4689-93
references.pmid: 7029524
references.citation: J Infect Dis. 2001 Feb 15;183(4):633-9
references.pmid: 11170990
references.citation: J Clin Microbiol. 2007 Jul;45(7):2249-56
references.pmid: 17494723
references.citation: Infect Immun. 2002 Apr;70(4):2171-7
references.pmid: 11895984
references.citation: J Clin Microbiol. 2005 Jul;43(7):3101-9
references.pmid: 16000420
references.citation: Science. 2008 Mar 7;319(5868):1405-8
references.pmid: 18323455
references.citation: Clin Infect Dis. 2004 Aug 1;39(3):325-32
references.pmid: 15306998
references.citation: J Exp Med. 1928 Jan 1;47(1):91-103
references.pmid: 19869404
references.citation: J Exp Med. 1959 Aug 1;110(2):271-92
references.pmid: 13673139
references.citation: J Exp Med. 1986 Jan 1;163(1):129-38
references.pmid: 2416864
references.citation: Lancet. 1990 Nov 10;336(8724):1167-71
references.pmid: 1978035
references.citation: Lancet Infect Dis. 2005 Nov;5(11):685-94
references.pmid: 16253886
references.citation: J Infect Dis. 1992 Aug;166(2):374-82
references.pmid: 1634809