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Abstract
Background
Group A Streptococcus (GAS) is responsible for a wide spectrum of human diseases. We investigated the distribution of emm types and antibiotic resistance rates of GAS from clinical specimens in several Korean medical centers.
Methods
A total of 192 strains of GAS from throat, blood, and other specimens collected in Seoul, Busan, Ulsan, Iksan, and Jeju were studied in 2008-2009. The emm genotypes were identified using PCR and sequencing. Antimicrobial susceptibility testing was performed by disk diffusion method. Phenotypes of macrolide resistance were evaluated, and macrolide resistance genes were determined by PCR.
Results
The emm89 (33.9%) was most frequently detected, followed by emm1 (12.5%), emm12 (8.3%), emm4 (7.8%), and emm75 (7.3%). The distribution of emm types did not show a close relation to the type of specimen and was different for each area. The resistance rates to erythromycin (ERY) and clindamycin (CLI) were 4.6% and 3.7%, respectively. Among the nine ERY-resistant strains, the rate of constitutive resistance was 88.9%, compared with 11.1% for the M phenotype. Five of the ERY-resistant strains were emm28.
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Fig. 1.
Frequency of emm genotypes in this study and study of acute pharyngitis in Jinju, 2009 [14].
Table 1.
Distribution of emm genotypes according to specimen type
Table 2.
Distribution of emm genotypes according to geographic region
Table 3.
Minimal inhibitory concentrations (MIC) of erythromycin (ERY) and macrolide-resistant determinants among ERY-resistant group A streptococci
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