A review of penicillin binding protein and group A Streptococcus with reduced-β-lactam susceptibility

Abstract

With the widespread use of antibiotics, antimicrobial resistance (AMR) has become a global problem that endangers public health. Despite the global high prevalence of group A Streptococcus (GAS) infections and the global widespread use of β-lactams, β-lactams remain the first-line treatment option for GAS infection. β-hemolytic streptococci maintain a persistent susceptibility to β-lactams, which is an extremely special phenomenon in the genus Streptococci, while the exact current mechanism is not known. In recent years, several studies have found that the gene encoding penicillin binding protein 2X (pbp2x) is associated with GAS with reduced-β-lactam susceptibility. The purpose of this review is to summarize the current published data on GAS penicillin binding proteins and β-lactam susceptibility, to explore the relationship between them, and to be alert to the emergence of GAS with reduced susceptibility to β-lactams.

Diagnostic Accuracy of Group A Streptococcus Rapid Antigen Detection Test on Middle Ear Fluid in Children With Acute Otitis Media With Spontaneous Perforation: A Prospective Multicenter Evaluation

“…15 However, GAS strains with reduced susceptibility to ß-lactams have been reported and justified surveillance and vigilance. 16 Of note, we did not identify any clinical parameter significantly associated with the presence of GAS in MEF culture. Furthermore, the frequency of GAS in otorrhea increased after the relaxation of nonpharmaceutical interventions introduced to mitigate the COVID-19 pandemic.…”

Increase in invasive group A streptococcal infections in Milan, Italy: a genomic and clinical characterization

“…In particular, the PBP2X mutations included M593T, found in 2/6 emm 12 strains, mutations I502V, P676S, and K708E, found in the emm 22 strain, S562T found in the emm 89 strain and mutations V241I, K213N, and T246A, found in the emm 58 strain. The M593T mutation was previously found to result in a 2-fold increase in penicillin G and ampicillin MIC when present in combination with the I502V, P676S, and K708E mutations (Yu et al, 2023 ). However, in our strains this mutation was always present as single PBP2X mutation, probably explaining why no change in the penicillin susceptibility could be observed.…”

Nanosilver: An Old Antibacterial Agent with Great Promise in the Fight against Antibiotic Resistance

“…Genes that encode alternate or modified antibiotic targets are also acquired by HGT. For example, methicillin-resistant strains of S. aureus (MRSA) are postulated to have received the gene mecA , which encodes a transpeptidase with a lowered affinity for methicillin, via HGT from a closely related ancestor [ 230 ], while chromosomal mutations in the genome of S. pneumoniae result in structural changes in the transpeptidases (involved in cell wall synthesis) and provide resistance to β-lactam antibiotic binding [ 231 ]. Emerging Mycobacterium tuberculosis ( Mtb )-resistant strains have mutations in the DNA-dependent RNA polymerase enzyme (RNAP) that alters the structure so that it is no longer vulnerable to catalytic inhibition by the antibiotic rifampicin [ 232 ].…”