title: High prevalence of fluoroquinolone-nonsusceptible Streptococcus pyogenes emm12 in Taiwan.
abstract: Fluoroquinolone-nonsusceptible Streptococcus pyogenes has rapidly emerged in several countries. The aim of this study was to survey the epidemiology and molecular characteristics of fluoroquinolone-nonsusceptible S. pyogenes in Taiwan. A total of 350 consecutive S. pyogenes isolates were collected between January 2005 and December 2012, including 152 (43.4%) invasive and 198 (56.6%) noninvasive isolates. Thirty-nine isolates (11.1%) of S. pyogenes were nonsusceptible to fluoroquinolones, including one emm1/ST28, 4 emm4/ST39, 33 emm12/ST36, and 1 emm87/ST62. Of all the isolates, emm12 (50%) demonstrated the highest prevalence of fluoroquinolone nonsusceptibility. Alterations of Ser79Phe and Ala12Val in ParC were the most frequently mutations in fluoroquinolone-nonsusceptible S. pyogenes isolates. There were no amino acid substitutions in GyrB, and 1 emm87 isolate exhibited 3 nonsynonymous mutations in ParE. Our study reveals the emergence of fluoroquinolone-nonsusceptible S. pyogenes emm12/ST36 in Taiwan. Regular surveillance of fluoroquinolone susceptibility in S. pyogenes is suggested.
authors.affiliation: Department of Critical Care Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan; School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan; Division of Infectious Diseases, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.
authors.forename: Jiun-Nong
authors.initials: JN
authors.lastname: Lin
authors.affiliation: Department of Microbiology, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Lin-Li
authors.initials: LL
authors.lastname: Chang
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.
authors.forename: Chung-Hsu
authors.initials: CH
authors.lastname: Lai
authors.affiliation: Department of Critical Care Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.
authors.forename: Yi-Han
authors.initials: YH
authors.lastname: Huang
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.
authors.forename: Wei-Fang
authors.initials: WF
authors.lastname: Chen
authors.affiliation: General Education Center, Meiho University, Pingtung, Taiwan.
authors.forename: Chih-Hui
authors.initials: CH
authors.lastname: Yang
authors.affiliation: Department of Microbiology and Immunology, McGill University, Montreal, Canada.
authors.forename: Janine
authors.initials: J
authors.lastname: Hsu
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.
authors.forename: Hsi-Hsun
authors.initials: HH
authors.lastname: Lin
authors.affiliation: School of Medicine, Sepsis Research Center, Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Biological Science and Technology, College of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan. Electronic address: infchen@gmail.com.
authors.forename: Yen-Hsu
authors.initials: YH
authors.lastname: Chen
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D027081:DNA Gyrase / Q000235:genetics; D027101:DNA Topoisomerase IV / Q000235:genetics; D024881:Drug Resistance, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D024841:Fluoroquinolones / Q000494:pharmacology*; D005838:Genotype; D006801:Humans; D058889:Molecular Typing; D020125:Mutation, Missense; D015995:Prevalence; D013290:Streptococcal Infections / Q000453:epidemiology* / Q000382:microbiology*; D013297:Streptococcus pyogenes / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification*; D013624:Taiwan / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D027101:DNA Topoisomerase IV; D027081:DNA Gyrase
keywords: Fluoroquinolone resistance; Group A streptococcus; Quinolone resistance-determining regions; Streptococcus pyogenes