POSSIBILITY FOR RAPID DIAGNOSIS OF GROUP A STREPTOCOCCUS-INDUCED SOFT TISSUE INFECTIONS, ANTIBIOTIC SENSITIVITY, AND MOLECULAR GENETIC FEATURES OF THE PATHOGEN
- Authors: BRIKO NI1, KLEYMENOV DA1, DMITRIEVA NF1, GLUSHKOVA EV1, LIPATOV KV1, KOZLOV RS2
-
Affiliations:
- I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
- Institute of Antimicrobial Chemotherapy, Smolensk State Medical Academy, Ministry of Health of Russia
- Issue: No 4 (2015)
- Pages: 27-33
- Section: Articles
- URL: https://journals.eco-vector.com/2226-6976/article/view/278290
- ID: 278290
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Abstract
Objective. To assess the possibilities of using the commercial test systems developed for the rapid identification of Group A streptococci (GAS) in the throat smears in soft tissue infections; to identify the emm types of isolated streptococci; to study their antibiotic sensitivity, and to determine the presence of the toxin genes in their genomes.
Materials and methods. The rapid test-system «STREPTATEST» and the classical microbiological method were applied. The medical records of patients with soft tissue infections treated at the Purulent Surgical Department, Medsantrud Clinical Hospital Twenty-Three (Moscow) in 2008-2011 were analyzed. A total of 118 GAS strains isolated from patients with streptococcal infection of soft tissues were investigated. Molecular genetic methods were used to determine the emm type of GAS and the presence of the speA, speB and speC toxin genes. The microdilution antibiotic sensitivity testing was performed using cation-adjusted Mueller Hinton broth (BBL, USA) supplemented with lysed horse blood (5% final concentration).
Results. The investigators determined 34 different GAS emm types belonging to 9 different emm clusters, out of which clusters D4, E2 and E4 proved to be most numerous. The emm-types 66, 88 and 169 (st1731) were most common (each
had more than 10 strains). Twenty-one cultures that were resistant to more than one antibiotic belonged to 11 emm genotypes. The speA gene was detected in a small proportion of invasive strains. No false-positive and false-negative results were recorded in the investigation using the rapid test.
Conclusion. A diversity of isolated GAS genotypes was established in the Moscow patients with soft tissue infections. At the same time, more than half of the emm types belong to the three clusters encompassing closely related M types. Identification of multidrug-resistant GAS strains underlines the need for monitoring the antibiotic sensitivity of isolates. The test system «STREPTATEST» has been shown to be promising in identifying GAS in patients with pyoinflammatory diseases of soft tissues during surgery.
Materials and methods. The rapid test-system «STREPTATEST» and the classical microbiological method were applied. The medical records of patients with soft tissue infections treated at the Purulent Surgical Department, Medsantrud Clinical Hospital Twenty-Three (Moscow) in 2008-2011 were analyzed. A total of 118 GAS strains isolated from patients with streptococcal infection of soft tissues were investigated. Molecular genetic methods were used to determine the emm type of GAS and the presence of the speA, speB and speC toxin genes. The microdilution antibiotic sensitivity testing was performed using cation-adjusted Mueller Hinton broth (BBL, USA) supplemented with lysed horse blood (5% final concentration).
Results. The investigators determined 34 different GAS emm types belonging to 9 different emm clusters, out of which clusters D4, E2 and E4 proved to be most numerous. The emm-types 66, 88 and 169 (st1731) were most common (each
had more than 10 strains). Twenty-one cultures that were resistant to more than one antibiotic belonged to 11 emm genotypes. The speA gene was detected in a small proportion of invasive strains. No false-positive and false-negative results were recorded in the investigation using the rapid test.
Conclusion. A diversity of isolated GAS genotypes was established in the Moscow patients with soft tissue infections. At the same time, more than half of the emm types belong to the three clusters encompassing closely related M types. Identification of multidrug-resistant GAS strains underlines the need for monitoring the antibiotic sensitivity of isolates. The test system «STREPTATEST» has been shown to be promising in identifying GAS in patients with pyoinflammatory diseases of soft tissues during surgery.
About the authors
N I BRIKO
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
Email: briko@mma.ru <mailto:briko@mma.ru>
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
D A KLEYMENOV
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
Email: 10000let@rambler.ru <mailto:10000let@rambler.ru>
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
N F DMITRIEVA
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
Email: dmitrieva@mma.ru <mailto:dmitrieva@mma.ru>
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
E V GLUSHKOVA
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
Email: ekaterina-1801@mail.ru <mailto:ekaterina-1801@mail.ru>
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
K V LIPATOV
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
Email: k_lipatov@mail.ru <mailto:k_lipatov@mail.ru>
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
R S KOZLOV
Institute of Antimicrobial Chemotherapy, Smolensk State Medical Academy, Ministry of Health of Russia
Email: roman@antibiotic.ru <mailto:roman@antibiotic.ru>
Institute of Antimicrobial Chemotherapy, Smolensk State Medical Academy, Ministry of Health of Russia
References
- Carapetis J.R., Steer A.C., Mulholland E.K., Weber M. The global burden of group A streptococcal diseases. Lancet Infect. Dis. 2005; 5: 685-694.
- Дмитриева Н.Ф., Трофимов Д.Ю., Ещина А.С., Ряпис Л.А., Скоркина Ю.А., Герасимов А.Н., Журавлев М.В. Брико Н.И. Частота встречаемости генов spe ABC в штаммах Streptococcus pyogenes и идентификация возбудителя с помощью ПЦР. Журн. микробиол. 2002; 5: 3-6.
- Sanderson-Smith M., De Oliveira D.M., Guglielmini J., McMillan D.J., Smeesters P.R. A systematic and functional classification of Streptococcus pyogenes that serves as a new tool for molecular typing and vaccine development. J. Infect. Dis. 2014; 210(8): 1325-1338.
- Fittipaldi N., Beres S.B., Olsen R.J., Kapur V., Musser J.M. Full-genome dissection of an epidemic of severe invasive disease caused by a hypervirulent, recently emerged clone of group A Streptococcus. Am. J. Pathol. 2012; 180(4): 1522-1534.
- Steer A.C., Law I., Matatolu L., Beall B.W., Carapetis J.R. Global emm type distribution of group A streptococci: systematic review and implications for vaccine development. Lancet Infect Dis. 2009; 10: 611-616.
- Moses A.E., Hidalgo-Grass C., Dan-Goor M., Jaffe J., Shetzigovsky I., Ravins M., Korenman Z., Cohen-Poradosu R., Nir-Paz R. emm typing of M nontypeable invasive group A Streptococcal isolates in Israel. J. Clin. Microbiol. 2003; 41(10): 4655-4659.
- Kittang B. R., Bruun T., Langeland N., Mylvaganam H., Glambek M., Skrede S. Invasive group A, C and G streptococcal disease in western Norway: virulence gene profiles, clinical features and outcomes. Clin. Microbiol. Infect. 2011; 17(3): 358-364.
- Lepoutre A., Doloy A., Bidet P., Leblond A., Perrocheau A., Bingen E., Trieu-Cuot P., Bouvet A., Poyart C., Lévy-Bruhl D. Epidemiology of invasive Streptococcus pyogenes infections in France in 2007. J. Clin. Microbiol. 2011; 49(12): 4094-4100.
- Shea P.R., Ewbank A.L., Gonzalez-Lugo J.H., Martagon-Rosado A.J., Martinez-Gutierrez J.C., Rehman H.A., Serrano-Gonzalez M., Fittipaldi N., Beres S.B., Flores A.R., Low D.E., Willey B.M., Musser J.M. Group A Streptococcus emm gene types in pharyngeal isolates, Ontario, Canada, 2002-2010. Emerg. Infect. Dis. 2011; 17(11): 2010-2017. 10.
- Yu-Fang Su, Shih-Min Wang, Ya-Lan Lin. Changing Epidemiology of Streptococcus pyogenes emm types and associated invasive and noninvasive infections in Southern Taiwan. J. Clin. Microbiol. 2009; 47(8): 2658-2661.
- Anand T.D., Rajesh T., Rajendhran J., Gunasekaran P. Superantigen profiles of emm and emm-like typeable and nontypeable pharyngeal streptococcal isolates of South India. Ann. Clin. Microbiol. Antimicrob. 2012; 11(3): 18-24.
- Fittipaldi N., Olsen R. J., Beres S. B., van Beneden C., Musser J.M. Genomic Analysis of emm59 group A streptococcus invasive strains, United States. EID Journal 2012; 18(4): 650-652.
- Cole J.N., Barnett T.C., Nizet V., Walker M.J. Molecular insight into invasive group A streptococcal disease. Nature Rev. Microbiol. 2011; 9: 724-736.
- Baroux N., D'Ortenzio E., Amédéo N. The emmcluster typing system for Group A Streptococcus identifies epidemiologic similarities across the pacific region. Clin. Infect. Dis. 2014; 59(7): 84-92.
- Green N. M., Zhang S., Porcella S. F., Nagiec M.J., Barbian K.D., Beres S.B., LeFebvre R.B., Musser J.M. Genome sequence of a serotype M28 strain of group А ОбычныйStreptococcus: potential new insights into puerperal sepsis and bacterial disease specificity. Infect. Dis. 2005; 192(5): 760-770.
- Брико Н.И., Глушкова Е.В., Носик А.Г., Дмитриев А.В., Дмитриева Н.Ф., Клейменов Д.А., Липатов К.В. Частота заболеваний, вызываемых стрептококками группы А, среди инвазивных инфекций мягких тканей, и характеристика возбудителя. Журн. микробиол. 2014; 5: 24-31.
- Ochel A., Rohde M., Chhatwal G.S., Talay S.R. The M1 Protein of Streptococcus pyogenes triggers an innate uptake mechanism into polarized human endothelial cells. J. Innate Immun. 2014; 6: 585-596.
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