title: Molecular epidemiology, antimicrobial susceptibility, and characterization of macrolide-resistant Streptococcus pyogenes in Japan.
abstract: Here we report the molecular epidemiology of macrolide-resistant Streptococcus pyogenes (group A streptococci, GAS) isolated from children with pharyngotonsillitis between 2011 and 2013 in Japan. In 299 isolates, 124 (41.5%) isolates were macrolide-resistant. We characterized the isolates by emm typing, multilocus sequence typing (MLST), and pulsed-field gel electrophoresis (PFGE). Of 299 isolates, 124 (41.5%) were macrolide-resistant isolates, 76 (61.3%) possessed mefA and 46 (37.1%) possessed ermB. All 76 isolates with mefA possessed msrD. There were no isolates possessed ermTR in this study. Eight emm/MLST types were observed. The predominant type was emm1/ST28 (57 isolates, 46.0%), which possessed the mefA/msrD complex, presenting as the M phenotype. The second most predominant type was emm12/ST467, which possessed ermB, presenting as the cMLSBphenotype. Of the cMLSBphenotype isolates, types emm28/ST52 and emm12/ST36 had multiple genetic backgrounds. We found high proportions of macrolide-resistant GAS in the southwestern areas of Japan.
authors.affiliation: Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Yuhei
authors.initials: Y
authors.lastname: Tanaka
authors.affiliation: Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, Japan. Electronic address: gotou_kenji@kurume-u.ac.jp.
authors.forename: Kenji
authors.initials: K
authors.lastname: Gotoh
authors.affiliation: Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Teramachi
authors.affiliation: Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Ishimoto
authors.affiliation: Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Tsumura
authors.affiliation: Shindo Children's Clinic, Fukuoka-shi, Japan.
authors.forename: Shizuo
authors.initials: S
authors.lastname: Shindou
authors.affiliation: Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Yushiro
authors.initials: Y
authors.lastname: Yamashita
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000942:Antigens, Bacterial / Q000378:metabolism; D001425:Bacterial Outer Membrane Proteins / Q000378:metabolism; D002648:Child; D024881:Drug Resistance, Bacterial / Q000187:drug effects*; D006801:Humans; D007564:Japan; D018942:Macrolides / Q000627:therapeutic use*; D008826:Microbial Sensitivity Tests / Q000379:methods; D017720:Molecular Epidemiology / Q000379:methods; D010641:Phenotype; D012141:Respiratory Tract Infections / Q000382:microbiology; D013290:Streptococcal Infections / Q000382:microbiology; D013297:Streptococcus pyogenes / Q000187:drug effects* / Q000302:isolation & purification* / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D000942:Antigens, Bacterial; D001425:Bacterial Outer Membrane Proteins; D018942:Macrolides
keywords: MLST; Macrolide-resistant; PFGE; Streptococcus pyogenes; emm typing