title: Antimicrobial susceptibility patterns, emm type distribution and genetic diversity of Streptococcus pyogenes recovered in Brazil.
abstract: Streptococcus pyogenes is responsible for a variety of infectious diseases and immunological complications. In this study, 91 isolates of S. pyogenes recovered from oropharynx secretions were submitted to antimicrobial susceptibility testing, emm typing and pulsed-field gel electrophoresis (PFGE) analysis. All isolates were susceptible to ceftriaxone, levofloxacin, penicillin G and vancomycin. Resistance to erythromycin and clindamycin was 15.4%, which is higher than previous reports from this area, while 20.9% of the isolates were not susceptible to tetracycline. The macrolide resistance phenotypes were cMLSB (10) and iMLSB (4). The ermB gene was predominant, followed by the ermA gene. Thirty-two emm types and subtypes were found, but five (emm1, emm4, emm12, emm22, emm81) were detected in 48% of the isolates. Three new emm subtypes were identified (emm1.74, emm58.14, emm76.7). There was a strong association between emm type and PFGE clustering. A variety of PFGE profiles as well as emm types were found among tetracycline and erythromycin-resistant isolates, demonstrating that antimicrobial resistant strains do not result from the expansion of one or a few clones. This study provides epidemiological data that contribute to the development of suitable strategies for the prevention and treatment of such infections in a poorly studied area.
authors.affiliation: Departamento de Microbiologia e Parasitologia, Instituto Biomédico, Universidade Federal Fluminense, Niterói, RJ, Brasil.
authors.forename: Glauber P
authors.initials: GP
authors.lastname: Arêas
authors.affiliation: Departamento de Microbiologia e Parasitologia, Instituto Biomédico, Universidade Federal Fluminense, Niterói, RJ, Brasil.
authors.forename: Rôde B B
authors.initials: RB
authors.lastname: Schuab
authors.affiliation: Departamento de Microbiologia e Parasitologia, Instituto Biomédico, Universidade Federal Fluminense, Niterói, RJ, Brasil.
authors.forename: Felipe P G
authors.initials: FP
authors.lastname: Neves
authors.affiliation: Departamento de Microbiologia e Parasitologia, Instituto Biomédico, Universidade Federal Fluminense, Niterói, RJ, Brasil.
authors.forename: Rosana R
authors.initials: RR
authors.lastname: Barros
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D015373:Bacterial Typing Techniques; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004917:Erythromycin / Q000494:pharmacology; D005260:Female; D014644:Genetic Variation / Q000235:genetics*; D005838:Genotype; D006801:Humans; D018942:Macrolides / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D009960:Oropharynx / Q000378:metabolism; D010403:Penicillin Resistance / Q000235:genetics*; D010641:Phenotype; D020539:Sequence Analysis, Protein / Q000379:methods; D013290:Streptococcal Infections / Q000453:epidemiology* / Q000517:prevention & control; D013297:Streptococcus pyogenes / Q000145:classification / Q000187:drug effects* / Q000235:genetics*; D020713:Vancomycin Resistance / Q000235:genetics*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D018942:Macrolides; D004917:Erythromycin