Characteristics of Group A<i>Streptococcus</i>Strains Circulating during Scarlet Fever Epidemic, Beijing, China, 2011

Yang, Peng; Peng, Xiaomin; Zhang, Daitao; Wu, Shanshan; Liu, Yimeng; Cui, Shujuan; Lu, Guilan; Duan, Wei; Shi, Weixian; Liu, Shuang; Li, Jing; Wang, Quanyi

doi:10.3201/eid1906.121020

Cited by 46 publications

(78 citation statements)

References 28 publications

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“…A large ongoing outbreak of scarlet fever in Hong Kong and mainland China is being monitored (109)(110)(111). Starting in 2011, there was an alarming increase in the number of scarlet fever cases, including Ͼ1,500 cases in Hong Kong (110) and over 6,000 cases in Beijing (111).…”

Section: Outbreaks Of Gas Diseasesmentioning

confidence: 99%

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Disease Manifestations and Pathogenic Mechanisms of Group A Streptococcus

et al. 2014

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SUMMARY Streptococcus pyogenes , also known as group A Streptococcus (GAS), causes mild human infections such as pharyngitis and impetigo and serious infections such as necrotizing fasciitis and streptococcal toxic shock syndrome. Furthermore, repeated GAS infections may trigger autoimmune diseases, including acute poststreptococcal glomerulonephritis, acute rheumatic fever, and rheumatic heart disease. Combined, these diseases account for over half a million deaths per year globally. Genomic and molecular analyses have now characterized a large number of GAS virulence determinants, many of which exhibit overlap and redundancy in the processes of adhesion and colonization, innate immune resistance, and the capacity to facilitate tissue barrier degradation and spread within the human host. This improved understanding of the contribution of individual virulence determinants to the disease process has led to the formulation of models of GAS disease progression, which may lead to better treatment and intervention strategies. While GAS remains sensitive to all penicillins and cephalosporins, rising resistance to other antibiotics used in disease treatment is an increasing worldwide concern. Several GAS vaccine formulations that elicit protective immunity in animal models have shown promise in nonhuman primate and early-stage human trials. The development of a safe and efficacious commercial human vaccine for the prophylaxis of GAS disease remains a high priority.

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Section: Outbreaks Of Gas Diseasesmentioning

confidence: 99%

“…Starting in 2011, there was an alarming increase in the number of scarlet fever cases, including Ͼ1,500 cases in Hong Kong (110) and over 6,000 cases in Beijing (111). The Chinese Ministry of Health reported a combined 110,000 cases of scarlet fever in mainland China in 2011 to 2012.…”

Section: Outbreaks Of Gas Diseasesmentioning

confidence: 99%

Disease Manifestations and Pathogenic Mechanisms of Group A Streptococcus

et al. 2014

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“…Although GAS can be treated with ␤-lactam drugs, such as penicillin and amoxicillin, because of its universal susceptibility to the class, macrolides are alternatives for patients allergic to penicillins (1). GAS resistance to macrolides varies significantly by geographic location, and it has been increasing in some areas (16)(17)(18)(19)(20). In the United States, based on a multicenter study conducted about a decade ago, erythromycin resistance of GAS ranged from 3.8% to 4.3% in different years (16).…”

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confidence: 99%

“…It is reported to be 8.2% in Germany (17) and 32.8% in Spain (18). It is highest in China, where more than 96% of GAS isolates are resistant (19,20). It has also been found that this is often clonally related, with certain emm genotypes predominant.…”

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confidence: 99%

Detection of Streptococcus pyogenes by Use of Illumigene Group A Streptococcus Assay

et al. 2013

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The performance of the Illumigene group A Streptococcus assay was evaluated by comparing it to culture using 437 consecutive throat swabs. The Illumigene assay was also directly compared to PCR with 161 samples. This Illumigene assay is rapid and easy to perform. The assay also has high sensitivity (100%) compared to culture or PCR and high specificity (99.2%) compared to PCR. A total of 8.8% of the isolates were erythromycin resistant, and 6.9% were clindamycin resistant. Streptococcus pyogenes (group A streptococcus [GAS]) causes various infections, including acute pharyngitis in children. Rapid and accurate laboratory diagnosis is important for antibiotic therapy that prevents rheumatic fever and probably invasive infections (1). Current standard testing methods include rapid antigen detection, with about 70 to 80% sensitivity, and culture, which takes 24 to 48 h (2). A new molecular method, the Illumigene group A Streptococcus assay, based on loop-mediated isothermal amplification (LAMP) technology for testing GAS, has been developed by Meridian Bioscience and has recently been cleared by the FDA. The target region of the assay is in the GAS pyrogenic exotoxin B (speB) gene (3,4). In this prospective study, the Illumigene group A Streptococcus assay was compared to standard bacterial culture and to PCR targeting the ptsI (phosphotransferase) gene to evaluate its clinical performance.Specimens. Throat swabs routinely submitted for GAS testing by rapid antigen and culture methods were collected from symptomatic children at Ann and Robert H. Lurie Children's Hospital of Chicago. Each specimen was collected with the double-swab system with a liquid Stuart transport medium (Copan Diagnostics, Inc., Murrieta, CA). One swab was used for rapid antigen assay. The second swab was used for culture and the Illumigene group A Streptococcus assay. No patient was enrolled into the study more than once. The study was approved by the Institutional Review Board of Ann and Robert H. Lurie Children's Hospital of Chicago.Illumigene group A Streptococcus assay. One swab was plated onto agar plates for culture and then was used to perform the Illumigene group A Streptococcus assay as described in the manufacturer's product insert. Briefly, the sample in the supplied sample preparation buffer was heated to 95°C for 10 min. Heated samples were transferred to "test" and "control" chambers that contained lyophilized amplification reagents. Both amplification and detection took place on the Illumipro-10 device. The whole process time from preparation to result reading for 1 to 10 specimens was approximately 1 h.Culture and susceptibility. Standard GAS culture was performed with 5% sheep blood agar. GAS identification was based on colony morphology, Gram stain, catalase test, and serogrouping using reagents from PathoDX Strep Grouping distributed by Remel, Lenexa, KS (2). Erythromycin, clindamycin, and levofloxacin susceptibility testing was performed with MICroSTREP Plus panels, and the results were read using the MicroScan Walkaway in...

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“…The emergence of a resistance emm 12 clone in China has aggravated the situation where 96% of GAS isolates were resistant to erythromycin (Yang et al, 2011). Resistance to tetracycline and fluoroquinolones has also been registered with 38% of the strains being resistant to the former globally (Ayer et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

Genome-wide analysis of Streptococcus pyogenes associated with pharyngitis and skin infections. (c2015)

Ibrahim¹

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Characteristics of Group AStreptococcusStrains Circulating during Scarlet Fever Epidemic, Beijing, China, 2011

Cited by 46 publications

References 28 publications

Disease Manifestations and Pathogenic Mechanisms of Group A Streptococcus

Disease Manifestations and Pathogenic Mechanisms of Group A Streptococcus

Detection of Streptococcus pyogenes by Use of Illumigene Group A Streptococcus Assay

Genome-wide analysis of Streptococcus pyogenes associated with pharyngitis and skin infections. (c2015)

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