González Pedraza-Avilés A, Ortiz-Zaragoza C, Mota-Vázquez R, Dickinson-Bannack ME, Dávila-Mendoza R, Fernández-Ortega MA

Language: Spanish
References: 28
Page: 437-441
PDF size: 42.85 Kb.

ABSTRACT

Objective. To evaluate the in vitro activities of 13 antimicrobial agents against 47 group A Streptococcus pyogenes (GAS) strains, and to determine the presence of genes encoding streptococcal pyrogenic exotoxin A (SpeA) and the M–protein serotypes. Materials and Methods. A crosssectional study was conducted at Centro de Salud Dr. José Castro Villagrana, during a scarlet fever outbreak occurring between December 1999 and January 2000, among 137 children at Colegio Espíritu de América. Minimum Inhibitory Concentrations (MICs) were obtained by the semiautomated microdilution method. Automated DNA sequencing was used for analysis of sequence variation in genes encoding the M protein, and SpeA. Results. All strains were sensitive to betalactams and clindamycin. Six (12.7%) were resistant to erythromycin. The M2 type was the most frequently isolated GAS (27); almost all (96%) bacteria with the SpeA gene had the gene encoding the M2 protein. Conclusions. The recent resurgence of GAS infections calls for molecular epidemiology research and studies on the sensitivity to macrolides and beta-lactams.

REFERENCES

1. Kaplan EL. The resurgence of group A streptococcal infections and their sequelae. Eur J Clin Microbiol Infect Dis 1991;10:55-57.

2. Spencer RC. Invasive streptococci. Eur J Clin Microbiol Infect Dis 1995; 14(Suppl 1):26-32.

3. Schwartz B, Facklam RR, Breiman RF. Changing epidemiology of group A streptococcal infection in the U.S.A. Lancet 1990;336:1167-1171.

4. Talkington DF, Schwartz B, Black CM, Todd JK, Elliot J, Breiman RF et al. Association of phenotypic and genotypic characteristics of invasive Streptococcus pyogenes isolates with clinical components of streptococcal toxic shock syndrome. Infect Immun 1993;61:3369-3374.

5. Curtis N. Invasive group A streptococcal infection. Curr Opin Infect Dis 1996;9:191-202.

6. Brook I. The role of beta-lactamase producing bacteria in the persistence of streptococcal tonsillar infection. Rev Infect Dis 1984;6:601-607.

7. Fitoussi F, Cohen R, Brami G, Doit C, Brahimi N, De la Rocque F et al. Molecular DNA analysis for differentiation of persistence or relapse from recurrence in treatment failure of Streptococcus pyogenes pharyngitis. Eur J Clin Microbiol Infect Dis 1997;16:233-237.

8. Arvand M, Hoeck M, Hahn H, Wagner J. Antimicrobial resistance in Streptococcus pyogenes isolates in Berlin. J Antimicrob Chemother 2000;46(4): 621-624.

9. Po-Ren H, Hung-Mo Ch, Ay-Huey H, Jiunn-Jomg W. Decreased activity of erythromycin against Streptococcus pyogenes in Taiwan. Antimicrob Agents Chemother 1995;39:2239-2242.

10. Connan K, Kaplan EL. In vitro susceptibility of recent North American Group A streptococcal isolates to eleven oral antibiotics. Pediatr Infect Dis J 1994;13:630-635.

11. National Comitee for Clinical Laboratory Standars. Performance standars for antimicrobial disk susceptibility test. Villanova (PA): National Comitte for Clinical Laboratory Standars, 1997. NCCLS document M2 A6.

12. National Comitte for Clinical Laboratory Standars. Methods for dilution antimicrobial susceptibility test for bacteria that grow aerobically. Villanova (PA): National Comitee For Clinical Laboratory Standars, 1997. NCCLS document M7 A4.

13. Perea-Mejía LM, Stockbauer KE, Pan X, Cravioto A, Musser JM. Characterization of group A Streptococcus strains recovered from Mexican children with pharyngitis by automated DNA sequencing of virulencerelated genes: Unexpectedly large variation in the gene (sic) encoding a complement-inhibiting protein. J Clin Microbiol 1997;35:3220-3224.

14. Whatmore AM, Kapur V, Sullivan J, Musser JM, Kehoe MA. Non-congruent relationships between variation in emm gene sequences and the population genetic structure of group A streptococci. Mol Microbiol 1994; 14:619-631.

15. Beall B, Facklam R, Thompson T. Sequencing emm-specific PCR products for routine and accurate typing of group A streptococci. J Clin Microbiol 1996;34(4):953-958.

16. Gaworzewska E, Colman G. Changes in the pattern of infection caused by Streptococcus pyogenes. Epidemiol Infect 1988;100:257-269.

17. Johnson DR, Stevens DL, Kaplan EL. Epidemiologic analysis of group A streptococcal serotypes associated with severe systemic infections, rheumatic fever, or uncomplicated pharyngitis. J Infect Dis 1992;166:374-382.

18. Espinoza-de los Monteros LE, Bustos IM, Flores LV, Avila-Figueroa C. Outbreak of scarlet fever caused by an erythromycin-resistant Streptococcus pyogenes emm 22 genotype strain in a day-care-center. Pediatr Infect Dis J 2001;20(8):807-809.

19. Shiseki M, Miwa K, Nemoto Y, Kato H, Susuki J, Sekiya K et al. Comparison of pathogenic factors expressed by group A streptococci isolated from patients with streptococcal toxic shock syndrome and scarlet fever. Microb Pathog 1999;27(4):243-252.

20. Stevens DL. Invasive group A streptococcal infections: The past, present and future. Pediatr Infect Dis J 1994;13:561-566.

21. Gené A, González-Cuevas A, Juncosa T, Luaces C, Latorre C. Sensibilidad antibiótica de Streptococcus pyogenes en pediatría. Enferm Infecc Microbiol Clin 1998;16:272-274.

22. Rodríguez RS, Calderón-Jaimes E, Gómez-Barreto D, Espinosa-de los Monteros LE. Antimicrobial resistance characteristics of clinical isolates of Streptococcus pyogenes. Salud Publica Mex 2000;42(3):226-229.

23. González-Pedraza AA, Ortiz-Zaragoza MC. Streptococcus pyogenes: susceptibilidad in vitro y papel de las bacterias productoras de betalactamasa en la persistencia de la faringoamigdalitis estreptocóccica. Aten Primaria 2000;25:542-545.

24. Henning C, Bengtsson L, Jorup C, Engquist S. Antibiotic resistance in Streptococcus pneumoniae, Haemophilus influenzae and Streptococcus pyogenes in respiratory tract infections in outpatients. Scand J Infect Dis 1997; 29(6):559-563.

25. Baquero F, García-Rodríguez JA, García-de Lomas, Aguilar L. Antimicrobial resistance of 914 beta-hemolytic streptococci isolated from pharyngeal swabs in Spain: Results of a 1-year (1996-1997) multicenter surveillance study. Antimicrob Agents Chemother 1999;43(1):178-180.

26. Melo-Cristino J, Fernández ML. Streptococcus pyogenes isolated in Portugal: Macrolide resistance phenotypes and correlation with T types. Portuguese surveillance group for the study of respiratory pathogens. Microb Drug Resist 1999;5(3):219-225.

27. Murayama S, Yoshioka H, Fojita K, Takimoto M, Satake Y. Sensitivity of group A streptococci to antibiotics. Am J Dis Child 1979;133:1143-1145.

28. Kataja J, Houvinen P, Skurnik M, Seppälä H. Erythromycin resistance in group A streptococci in Finland. The Finnish study group for antimicrobial resistance. Antimicrob Agents Chemother 1999;43(1):48-52.