A 23-Year Longitudinal Study on the Antibiotic Sensitivities of Group A Streptococci from the Scarlet Fever Patients During the Period, 1956-1978

Abstract

Among the group A streptococci isolated during the period 1956 to 1978 from the pharynx and the nostril of the scarlet fever patients quarantined in the Tokyo Metropolitan Toshima Hospital within 1 week of hospitalization, 1,586 strains of types 4, 6 and 12, the most prevalent serotypes, were estimated for their sensitivities to various antibiotics. Among the sensitivities, those to tetracycline (TC), chloramphenicol (CP) and erythromycin (EM), these being in close relation to prevalent serotypes, are to be reported. The first appearance of TC-resistant strain was seen in one strain (type 6) isolated in 1959, and, in 1964, the resistant strain increased in proportion in accordance with the prevalence of type 4. The resistant strain decreased a little in 1968 and in 1969, increased again from 1970, exceeded over 90% from 1973, and reached 100% in 1978. The first appearance of CP-resistant strain was seen in one strain (type 4) isolated in 1969, and then the resistant strain increased year by year along with the prevalence of type 12. The first appearance of EM-resistant strain was seen in 30 strains (type 12) isolated in 1972, and then, similarly to the case of CP-resistance, the resistant strain increased year by year together with the prevalence of type 12. Meanwhile, among the 1,586 strains isolated at the time of hospitalization and estimated of their minimum inhibitory concentrations (MIC), 932 strains (58.8%), 452 strains (28.5%), and 574 strains (36.2%) showed resistance to TC, CP, and EM, respectively. Variations of drug-resistance by serotypes were as follows: TC-resistant strains increased in accordance with the prevalence of type 4 in 1964; CP- and EM-resistant strains increased in accordance with the prevalence of type 12 in 1972; and type 6 strains were low in the rate of resistant strain to any of the three drugs. So far, prevalence of a serotype of group A streptococci has been considered to be caused by the accumulation of the subjects non-immune to the serotype. In the present study, a phenomenon was observed that prevalence of a serotype was effected by the state of resistance-acquisition to commonly used drugs. It would be clear that the resistance-acquisition plays, in addition to the immune state, a great role in evoking prevalence of a serotype.

Characteristics of Streptococcus pyogenes strains isolated from Chinese children with scarlet fever

“…They were responsible for about 95.9% of the scarlet fever cases in the two cities. The most frequent emm types in our study were similar to the research made in Taiwan (2,5), but different from the results found in Denmark (27) and Hungary (28). The diversities may be caused by differences in patients' ages, geographic locations or bacterial mutations.…”

“…Macrolides constitute the alternative choices for the treatment of S. pyogenes infections, especially in patients previously allergic to β‐lactams. However, the first tetracycline‐resistant, erythromycin‐resistant and chloramphenicol‐resistant strains were observed in 1959, 1972 and 1969, respectively (2). It was further discovered that after the late 1990s the prevalence of erythromycin‐resistant S. pyogenes had significantly increased in several European countries (3).…”

Prevalence and persistence of certain serologic types of Streptococcus pyogenes in metropolitan Tokyo

“…25,26 In this report, however, data obtained by that method for TC (tetracycline), CP (chloramphenicol), EM (erythromycin), and Pc (penicillin) were converted according to the National Committee for Clinical Laboratory Standards (NCCLS) criteria. 27 The drug susceptibility was determined for 1586 S. pyogenes isolates of M4, M6, and M12 types.…”