Molecular Characteristics of Streptococcus pyogenes Isolated From Chinese Children With Different Diseases

Abstract

Streptococcus pyogenes is a bacterial pathogen that causes a wide spectrum of clinical diseases exclusively in humans. The distribution of emm type, antibiotic resistance and virulence gene expression for S. pyogenes varies temporally and geographically, resulting in distinct disease spectra. In this study, we analyzed antibiotic resistance and resistance gene expression patterns among S. pyogenes isolates from pediatric patients in China and investigated the relationship between virulence gene expression, emm type, and disease categories. Forty-two representative emm1.0 and emm12.0 strains (n = 20 and n = 22, respectively) isolated from patients with scarlet fever or obstructive sleep apnea-hypopnea syndrome were subjected to whole-genome sequencing and phylogenetic analysis. These strains were further analyzed for susceptibility to vancomycin. We found a high rate and degree of resistance to macrolides and tetracycline in these strains, which mainly expressed ermB and tetM. The disease category correlated with emm type but not superantigens. The distribution of vanuG and virulence genes were associated with emm type. Previously reported important prophages, such as φHKU16.vir, φHKU488.vir, Φ5005.1, Φ5005.2, and Φ5005.3 encoding streptococcal toxin, and integrative conjugative elements (ICEs) such as ICE-emm12 and ICE-HKU397 encoding macrolide and tetracycline resistance were found present amongst emm1 or emm12 clones from Shenzhen, China.

Epidemiological analysis of Group A streptococcus infection diseases among children in Beijing, China under COVID-19 pandemic

“…In this study, we presented distribution of emm types including 13 emm types and 11 sAgs. Types emm12.0 and emm1.0 exhibited higher polymorphism rate which were similar with our previous study as well as Yu' study from 2016 to 2018 [9]. They were responsible for about 73.81% of scarlet fever cases in our present study.…”

“…Resistance rate of macrolides in our present study was still high compared with our previous studies from 2016 to 2017, and 2019. Yu found that from 2016 to 2018, 342 GAS strains were highly susceptible to penicillin, levofloxacin, and chloramphenicol, whereas most of strains were resistant to azithromycin, erythromycin, clarithromycin, clindamycin, and tetracycline [ 9 ]. Since 1990, the resistance rate of GAS against clindamycin and macrolides has been high [ 7 ].…”

“…Antibiotic resistance increases gradually, causing global concern [ 9 ]. Resistance of isolates to antibiotic varies in different countries and regions [ 10 , 11 ].…”

“…Scarlet fever in children was high incidence and case-fatality [6]. Comparing with USA, GAS infection in China was usually presented in non-invasive GAS infection [7,8] Antibiotic resistance increases gradually, causing global concern [9]. Resistance of isolates to antibiotic varies in different countries and regions [10,11].…”

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

“…A key exception to Fleming 's warning about the relationship between antimicrobial use and the development of resistance is the persistent susceptibility of GAS to b-lactam antibiotics (Horn et al, 1998). Eighty years after the introduction of penicillin, GAS strains still maintain consistent susceptibility to various b-lactams, and even the MICs of GAS to blactams remain low and stable (Yu et al, 2021a). The reasons for the persistent susceptibility of GAS to b-lactams are unclear, but may include differences in the rate and mechanism of horizontal gene transfer between GAS and other Streptococci.…”