Molecular characterization and antimicrobial resistance of group A streptococcus isolates in streptococcal toxic shock syndrome cases in Japan from 2013 to 2018
Molecular characterization and antimicrobial resistance of group A streptococcus isolates in streptococcal toxic shock syndrome cases in Japan from 2013 to 2018
复制标题
DOI：
10.1016/j.ijmm.2021.151496
复制
发表时间：
2021-03-21
影响因子：
4.1
通讯作者：
Ohnishi, Makoto
中科院分区：
文献类型：
--
作者：
Ikebe, Tadayoshi;Okuno, Rumi;Ohnishi, Makoto
链球菌中毒性休克综合征（STSS）是一种严重的侵袭性感染，其特征是突然发生休克、多器官功能衰竭和产后脓毒症，死亡率高。其主要原因是A组链球菌（GAS，化脓性链球菌）。在这项研究中，我们对2013-2018年从日本STSS患者中获得的621株GAS分离株的细胞表面M毒力蛋白基因（emm）进行了基因分型，并使用肉汤微量稀释法进行了抗菌药物敏感性试验。发现主要的emm类型是1，其次是89，12和3，在超过70%的STSS分离株中鉴定出。emm 3和emm 89的比例分别从2010-2012年的2.4%和12.0%增加到2013-2018年的5.6%和23.3%。相反，在同样的两个时期，emml的比例从60. 6%下降到39. 3%。一些emm类型显示比例增加，并且在2010-2012年未从STSS患者中分离出来。其中，emm 76型的流行率增加，并且不包括在基于30价M蛋白的疫苗中。对引起STSS的GAS流行病学变化的持续调查可以提供有用的监测信息，例如未来的疫苗接种策略和抗生素耐药菌的出现状况。
Streptococcal toxic shock syndrome (STSS) is a severe invasive infection characterized by the sudden onset of shock, multi-organ failure, and puerperal sepsis and shows high mortality. Its primary cause is group A streptococcus (GAS, Streptococcus pyogenes). In this study, we genotyped the cell-surface M virulence protein gene (emm) from 621 GAS isolates obtained from patients with STSS in Japan in 2013-2018 and performed antimicrobial susceptibility testing using the broth microdilution method. The predominant emm type was found to be 1, followed by 89, 12, and 3, which were identified in more than 70 % of STSS isolates. The proportions of emm3 and emm89 increased from 2.4 % and 12.0 %, respectively, during 2010-2012 to 5.6 % and 23.3 % during 2013-2018. In contrast, the proportion of emml decreased from 60.6 % to 39.3 % during the same two periods. Some emm types showed increasing proportions and were not isolated from patients with STSS in 2010-2012. Among these, an emm76 type increased in prevalence and was not included in the 30-valent M protein-based vaccine. Continual investigation of changes in the epidemiology of GAS which causes STSS can provide useful monitoring information such as future vaccination strategies and the emergence status of antimicrobial-resistant bacteria.