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European Journal of Clinical Microbiology & Infectious Diseases

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01-11-2021 | Necrotizing Fasciitis | Original Article

Invasive Streptococcus pyogenes disease in Spain: a microbiological and epidemiological study covering the period 2007–2019

Authors: Pilar Villalón, Juan A. Sáez-Nieto, Virginia Rubio-López, María José Medina-Pascual, Noelia Garrido, Gema Carrasco, Silvia Pino-Rosa, Sylvia Valdezate

Published in: European Journal of Clinical Microbiology & Infectious Diseases | Issue 11/2021

Abstract

The aim of this study is to present the first nationwide microbiological and epidemiological study of invasive group A Streptococcus (iGAS) disease in Spain. One thousand eight hundred ninety-three iGAS isolates were analyzed over 2007–2019. emm typing was performed by sequencing the gene’s variable 5’ end, exotoxin genes were identified by PCR, and antimicrobial susceptibility explored via the E test and disk diffusion. Five hundred twenty-three isolates were associated with sepsis, 292 with cellulitis, 232 with scarlet fever, 153 with pneumonia, 141 with streptococcal toxic shock syndrome, and 94 with necrotizing fasciitis. The most prevalent emm types were emm1 (449/1893 isolates), emm89 (210/1893), emm3 (208/1893), emm4 (150/1893), emm12 (112/1893) emm6 (107/1893), emm87 (89/1893), emm28 (88/1893), emm75 (78/1893), emm77 (78/1893), emm11 (58/1893), and emm22 (35/1893). emm1, emm3, emm4, and emm6 were the predominant types affecting children (mostly respiratory infections), while emm11, emm77, and emm89 prevailed in the elderly (mostly skin infections). Each emm type was associated with one or more exotoxin gene (spe, sme, and ssa) profiles. speA was detected in 660 isolates, speB in 1829, speC in 1014, speF in 1826, speG in 1651, speJ in 716, speH in 331, smeZ in 720, and ssa in 512. Isolates with speA were associated with the most severe infections. Penicillin susceptibility was universal. Two hundred twenty-four isolates were resistant to tetracycline, 169 to erythromycin, and 81 to clindamycin. Tetracycline, erythromycin, and clindamycin resistance rates declined over the study period. The above information could serve as the basis for continued surveillance efforts designed to control disease cause by this bacterium.

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Title: Invasive Streptococcus pyogenes disease in Spain: a microbiological and epidemiological study covering the period 2007–2019
Authors: Pilar Villalón
Juan A. Sáez-Nieto
Virginia Rubio-López
María José Medina-Pascual
Noelia Garrido
Gema Carrasco
Silvia Pino-Rosa
Sylvia Valdezate
Publication date: 01-11-2021
Publisher: Springer Berlin Heidelberg
Keywords: Necrotizing Fasciitis
Streptococci
Erythromycin
Clindamycin
Tetracyclines
Published in: European Journal of Clinical Microbiology & Infectious Diseases / Issue 11/2021
Print ISSN: 0934-9723
Electronic ISSN: 1435-4373
DOI: https://doi.org/10.1007/s10096-021-04279-2

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