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J Med Microbiol 55 (2006), 1115-1123; DOI: 10.1099/jmm.0.46481-0
© 2006 Society for General Microbiology
ISSN 1473-5644

Superantigen gene profile, emm type and antibiotic resistance genes among group A streptococcal isolates from Barcelona, Spain

Alba Rivera1,4, Montserrat Rebollo1, Elisenda Miró1, Míriam Mateo2, Ferran Navarro1,4, Mercé Gurguí3, Beatriz Mirelis1,4 and Pere Coll1,4

1 ,2 ,3 Servei de Microbiologia1 , Servei de Medicina Interna2 and Unitat de Malalties Infeccioses3 , Hospital de la Santa Creu i Sant Pau, Avda Sant Antoni Ma Claret 167, 08025 Barcelona, Spain

4 Unitat de Microbiologia, Departament de Genètica i Microbiologia, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallès (Bellaterra), Spain

Correspondence
Ferran Navarro
fnavarror{at}santpau.es

Received 21 December 2005
Accepted 18 April 2006

Group A streptococcus (GAS) has been described as an emerging cause of severe invasive infections. A retrospective hospital-based study was conducted, including GAS isolates causing invasive or non-invasive infections from January 1999 to June 2003 in Barcelona. Demographic and clinical information on the invasive cases was obtained from medical files. GAS isolates collected from 27 patients with invasive infections and 99 patients with non-invasive infections were characterized by emm type and subtype, superantigen (SAg) gene profile (speA–C, speF–J, speL, speM, ssa and smeZ), allelic variants of speA and smeZ genes, antibiotic susceptibility and genetic resistance determinants. The most prevalent emm type was emm1 (17.5 %), followed by emm3 (8.7 %), emm4 (8.7 %), emm12 (7.1 %) and emm28 (7.1 %). The smeZ allele and SAg gene profiles were closely associated with the emm type. The speA2, speA3 and speA4 alleles were found in emm1, emm3 and emm6 isolates, respectively. Overall, 27.8, 25.4 and 11.9 % of isolates were resistant to erythromycin, tetracycline or both agents, respectively. Reduced susceptibility to ciprofloxacin and levofloxacin (MIC 2–4 µg ml–1) was found in 3.2 % of isolates. mef(A)-positive emm types 4, 12 and 75, and erm(B)-positive emm types 11 and 25 were responsible for up to 80 % of the erythromycin-resistant isolates. No significant differences in emm-type distribution, SAg gene profile or resistance rates were found between invasive and non-invasive isolates. The SAg and antibiotic resistance genes appeared to be associated with the emm type and were independent of the disease type.

Abbreviations: GAS, group A streptococcus; NF, necrotizing fasciitis; SAg, superantigen; STSS, streptococcal toxic shock syndrome.

The GenBank/EMBL/DDBJ accession numbers for emm1.25, emm12.27, emm83.4, smeZ-35, smeZ-36, smeZ-37, smeZ-38 and smeZ-39 are AY686603, AY742805, AY742806, AY965265, AY965878, AY965879, DQ001538 and DQ001539, respectively.




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