1. Molecular characterization of invasive Streptococcus pyogenes isolates in Hungary from 2004 to 2006
BARBARA KRUCSÓ 1, dr. MÁRIA GACS 2, dr. BALÁZS LIBISCH 2,, ZSUZSANNA VARGÁNÉ HUNYADI1, GABRIELLA HAJBEL-VÉKONY1, JUDIT PÁSZTI1
1 Department of Phage and Molecular Typing, National Center for Epidemiology, Hungary
2 Department of Bacteriology, National Center for Epidemiology, Hungary
Abstract
The aim of the authors was to characterize 38 clinical isolates of group A streptococcus (GAS), collected from patients with severe invasive infections: STSS, sepsis, meningitis, necrotizing fascitis in Hungary from 2004 to 2006.
All isolates were examined by determining their susceptibility to antimicrobial agents, PFGE, emm typing and detection of streptococcal pyrogenic exotoxin genes (speA, speB and speC).
Predominant type was emm1, but other types (emm 3, emm 4, emm 28, emm 66, emm 80, emm 81.1, emm 82, emm 84, emm 108) were also identified. 10 different PFGE types were distinguished. All isolates carried the speB gene, and all the emm1 isolates had the speA toxin gene.
The PFGE types and emm types well correlated. 3 GAS strains were resistant to erythromycin and clindamycin. This study may help to reveal the most prevalent virulence determinants of invasive GAS infections in Hungary.
PCR and sequence analysis of the emm gene was performed for all of the strains according to the protocols described at
protocols.html.
Detection of streptococcal pyrogen exotoxin genes (speA, speB and speC) was performed as described earlier (1).
Pulsed-field Gel Electrophoresis with SmaI emzyme was performed according to Goering and Winters (2).
All isolates were examined by determining their susceptibility to erythromycin, clindamycin and levofloxacin as recommended by CLSI, 2005. 3
Table 2. emm type, presence of speA, B, C genes and PFGE pattern of 38 invasive Streptococcus pyogenes strains.
Conclusions
10 emm types and 11 PFGE profiles were observed. The prevalent emm types were: emm1, emm81, and emm28, emm 80, emm84. Out of which emm1 and emm28 are worldwide disseminated, although overall increase of new types were reported in Europe (3).
The following emm types were also observed in the invasive samples: emm 3, emm 4, emm66, emm 108.
We found speA in emm 1 and emm 3 strains, which connected with invasivity.
Three strains were resistant to erythromycin and clindamycin.
This report provides molecular epidemiological information of invasive streptococcal infections from 10 counties of Hungary. This work may help to understand the pathogenesis of invasive GAS disease in Hungary.
Results
Purpose of the study
In 2004 we started an investigation on strepto- coccal diseases and their clinical and epidemio-logical problems in Hungary.
We recorded clinical data about the collected invasive Hungarian Streptococcus pyogenes isolates.
to examine the Hungarian invasive Streptococcus pyogenes isolates by emm sequencing, speA, speB, speC toxin determination, and PFGE analysis among the strains originated from different infections.
References
Methods
Vlaminckx et al. J Clin Microbiol 41(11):
Goering and Winters 1992, J Clin Microbiol, 30:
38 S. pyogenes isolates were examined: 6 from 2004, 19 from 2005, 13 from 2006.
The strains originated from 10 counties (Budapest and Pest, Bács-Kiskun, Borsod-Abaúj-Zemplén, Békés, Fejér, Heves, Nógrád, Somogy, Vas).
Table 1. The clinical diagnosis, sex, age, source, and emm type of 38 invasive Streptococcus pyogenes isolates.