Decoding the molecular epidemiology of group A streptococcus - an Indian perspective
Decoding the molecular epidemiology of group A streptococcus - an Indian perspective
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DOI：
10.1099/jmm.0.001018
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发表时间：
2019-07-01
影响因子：
3
通讯作者：
Sistla, Sujatha
中科院分区：
文献类型：
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作者：
Abraham, Tintu;Sistla, Sujatha
目的。与西方国家不同，印度对A群链球菌（GAS）流行病学的了解仍然不完整。分型对于监测和预测多价M蛋白疫苗的效力至关重要。本研究旨在探讨来自南印度的206株侵袭性和非侵袭性GAS分离株的emm类型，并回顾所有已发表的关于印度GAS分子流行病学的文献，从而产生一个泛印度的数据，以预测30价m蛋白疫苗在该人群中的推测覆盖率。GAS的emm分型、超抗原（SAg）分析及印度GAS分子流行病学文献综述。研究结果表明，emm的类型具有较高的多样性，其中emm 63、82、183、85、92、169、42、44、106、74、12属于20个emm簇。关于流行emm类型的泛印度数据进一步支持了我们的研究结果，其中包含135种不同类型的emm。其中，E3（26%）、E6（20%）、E2（11%）、E4（10%）、D4（7%）、E1（6%）占80%。emm类型与感染性质之间无显著相关性（P >= 0.05），而一些SAg谱与某些emm类型有显著相关性。Pan Indian的数据显示，仅16%的emm类型包含在拟议的基于30价M蛋白的疫苗中。南印度GAS分离株的覆盖率为28.2%，在交叉opsonic效应下仅增加到46.6%，从而突出了开发一种包括印度流行的emm类型的特异性多价疫苗或考虑使用保守的c重复序列疫苗和非m蛋白疫苗的重要性。
Purpose. Unlike western countries the knowledge of group A streptococcus (GAS) epidemiology in India remains patchy and incomplete. Typing is crucial for surveillance as well as in predicting the efficacy of multivalent M protein vaccine. The present study aimed to explore the emm types of 206 invasive and non-invasive GAS isolates from South India as well as reviewing all the published literature on GAS molecular epidemiology from India thereby generating a pan-Indian data to predict the conjectural coverage of the 30-valent M-protein vaccine in this population.Methodology. emm typing and superantigen (SAg) profiling of GAS along with reviewing literatures on GAS molecular epidemiology from India.Results. This study revealed a high diversity of emm types with emm 63, 82, 183, 85, 92, 169, 42, 44, 106, 74, 12 being frequently encountered, belonging to twenty emm clusters. The pan-Indian data on prevalent emm types further supports our study findings with 135 emm different types. Six clusters dominated accounting for 80 % of the GAS isolates: E3(26 %), E6(20 %), E2(11 %), E4(10 %), D4(7 %), E1(6 %). No significant association was noted between emm types and the nature of infection (P >= 0.05) while a few SAg profiles were significantly associated with certain emm types. Pan Indian data revealed that only 16 % of the emm types encountered were included in proposed 30-valent M protein based vaccine.Conclusion. The coverage among the South Indian GAS isolates was 28.2 % which increased to only 46.6 % with the cross-opsonic effect, thus highlighting the importance of developing a specific multivalent vaccine including the prevalent emm types in India or considering the use of conserved C-repeat vaccines and non-M protein based vaccines.