To determine the carrier rate of beta-hemolytic streptococci (BHS), throat cultures were taken from healthy elementary school children in four separate areas of Korea from 1992 to 1995, including Inje, Nonsan, Seoul and Chinju. The strains of Streptococcus pyogenes had been serotyped with anti-T, -OF and -M sera. The isolation rates of BHS and S. pyogenes ranged from 14.1-32.4% and 10.9-18.5% respectively. More than half of the carriers showed heavy growth of BHS. M78 (48.6%) and M28 (22.2%) were most common in Inje, M12 (23.6%) and M5 (20.3%) in Nonsan, M12 (48.8%) and M5 (14.6%) in Seoul, and M12 (26.3%) and M22 (14.5%) in Chinju, respectively. About 15% of school children were positive for S. pyogenes in throat cultures, and the distribution of serotypes varied according to geographical regions.
Carrier State ; Child ; Child, Preschool ; Female ; Human ; Male ; Pharynx/microbiology* ; Schools ; Serotyping* ; Streptococcus pyogenes/isolation & purification* ; Streptococcus pyogenes/classification*

OBJECTIVETo study the prevalence rate of upper respiratory tract group A Streptococcus (GAS) carriage in school-age children from Xinjiang Province.

METHODSA total of 478 children at age of 9-12 years from Tulufan City and Buerjin County of Xinjiang Province were enrolled by random cluster sampling. Throat swab cultures were performed once each season for the determination of presence of GAS.

RESULTSIn the 1 827 samples, 196 GAS strains were isolated, with a GAS carrier rate of 10.7%. The prevalence rate of GAS carrier in Tulufan City ranged from 3.7%-16.5% compared with 4.7%-21.4% in Buerjin County (P < 0.05). The prevalence rate of GAS carrier in winter is the highest, followed by in autumn, spring and summer in both regions. There were significant differences in the GAS carriage rate in autumn between the two regions. There were no significant differences in the GAS carriage rate between boys and girls. Of the 196 GAS strains, 133 from Han, 22 from Uygur and 41 from Hazakh children. There were significant differences in the prevalence rate of GAS carriage among children with different ethic groups.

CONCLUSIONSThe prevalence rate of GAS carriage is high in school-age children from Tulufan and Buerjin of Xinjiang Province. The GAS carrier rate is associated with the season and ethic group. The children from Buerjin County present a higher GAS carrier rate than those from Tulufan City.

Carrier State ; microbiology ; Child ; China ; Female ; Humans ; Male ; Prevalence ; Respiratory System ; microbiology ; Streptococcus pyogenes ; isolation & purification

Lysins are murein hydrolases produced by bacteriophage that act on the cell wall of host bacteria to release progeny phages. Research indicated that lysins could kill bacteria effectively and specifically in vitro. To prepare recombinant bacteriophage lysin of Streptococcus (PlyC) and analyze its biological activity, we obtained two genes of PlyC named PlyCA and PlyCB by PCR amplification and inserted them into pET-32a(+), then transformed the recombinant expression vectors pET-32a(+)-PlyCA and pET-32a(+)-PlyCB into E. coli BL21(DE3) respectively. After induction with 0.7 mmol/L IPTG at 30 degrees C for 7 h, PlyCA and PlyCB were successfully expressed, SDS-PAGE analysis determined that they all constituted above 30% of the total cell proteins. After Ni(2+)-NTA affinity chromatography, the purity was more than 95%. With the denaturation and protein refolding, we gained the recombinant PlyC. To determine its biological activity, we adopted turbidimetry and plate count method. Before and after lysin treatment, the cell morphology was studied by scanning electron microscopy (SEM). The results showed that the recombinant PlyC could specifically cleavage Streptococcus pyogenes (group A beta-hemolytic streptococci). Under the incubation time of 60 min with 4 microg/mL PlyC in Streptococcus pyogenes dilution which OD600 was 0.56, the germicidal effect was up to 99.6%, while SEM observations showed that cell wall cracked and presented cell debris. This finding laid the foundation for the further study and achieving an effective treatment for streptococcal infection.
Bacteriolysis ; Enzymes ; biosynthesis ; genetics ; isolation & purification ; Escherichia coli ; genetics ; metabolism ; Recombinant Proteins ; biosynthesis ; genetics ; isolation & purification ; Streptococcus pyogenes ; drug effects

Seventy-seven Streptococcus pyogenes strains isolated of children of three elementary schools located in Kangwon-do in spring, 1992 were serotyped with M, opacity factor (OF) and T typing antisera. In the M/OF typing results, M-78 (46.8%) and M-28 (22.1%) were most frequently encountered, while M-4 (6.5%), M-12 (5.2%), M-3 (1.3%), M-5 (1.3%) and M-6 (1.3%) were rarely observed. Twelve strains (15.6%) were not typable with M or OF typing system. In the T typing results, T-11 (35.1%) and T-28 (27.3%) were most common. We were able to identify 77.9% of S. pyogenes strains by T typing, 94.8% with T typing and OF typing. With the addition of M typing, 97.4% were typable. Through the serotypings, we could know the basic distribution of serotypes of S. pyogenes of healthy children which could be comparable to those of rheumatic fever, poststreptococcal glomerulonephritis and other severe streptococcal disease.
Adolescent ; Bacterial Typing Techniques ; Child ; Female ; Humans ; Korea ; Male ; Pharynx/microbiology ; Rheumatic Fever/microbiology ; Serotyping ; Streptococcus pyogenes/*classification/isolation & purification

PURPOSE: Erythromycin-resistant beta-hemolytic streptococci (BHS) has recently emerged and quickly spread between and within countries throughout the world. In this study, we evaluate the antimicrobial susceptibility patterns and erythromycin resistance mechanisms of BHS during 2003-2004. MATERIALS AND METHODS: The MICs of seven antimicrobials were determined for 204 clinical isolates of BHS from 2003 to 2004. Resistance mechanisms of erythromycin-resistant BHS were studied by the double disk test as well as by polymerase chain reaction (PCR). RESULTS: Compared with our previous study, resistance among Streptococcus pyogenes isolates to a variety of drugs decreased strikingly: from 25.7% to 4.8% in erythromycin; 15.8% to 0% in clindamycin; and 47.1% to 19.0% in tetracycline. The prevalent phenotypes and genotypes of macrolide-lincosamide-streptograminB (MLSB) resistance in Streptococcus pyogenes isolates have been changed from the constitutive MLSB phenotype carrying erm(B) to the M phenotype with mef(A) gene. In contrast with Streptococcus pyogenes, resistance rates to erythromycin (36.7%), clindamycin (43.1%), and tetracycline (95.4%) in Streptococcus agalactiae isolates did not show decreasing trends. Among the Streptococcus dysgalactiae subsp. equisimilis isolates (Lancefield group C, G), resistance rates to erythromycin, clindamycin, tetracycline and chloramphenicol were observed to be 9.4%, 3.1%, 68.8%, and 9.4%, respectively. CONCLUSION: Continual monitoring of antimicrobial resistance among large-colony-forming BHS is needed to provide the medical community with current data regarding the resistance mechanisms that are most common to their local or regional environments.
Anti-Bacterial Agents/*pharmacology ; Drug Resistance, Multiple, Bacterial ; Erythromycin/*pharmacology ; Genes, Bacterial ; Genotype ; Hospitals ; Humans ; Incidence ; Korea ; Microbial Sensitivity Tests ; Streptococcus/*drug effects/genetics/isolation & purification ; Streptococcus agalactiae/drug effects/genetics/isolation & purification ; Streptococcus pyogenes/drug effects/genetics/isolation & purification

BACKGROUND: Acute pharyngitis is a very common respiratory tract infection. Rapid antigen tests (RATs) that detect group A streptococci (GAS) have an advantage over conventional throat culture in determining the cause of acute pharyngitis quickly. The efficiency of RAT should be good enough to be used in the laboratory or in the clinics. METHODS: From October 2008 through February 2009, throat swabs were taken from 293 children with acute pharyngitis and conveyed to the Gyeongsang National University Hospital in a transport medium. Two swabs from each patient were inoculated onto a blood agar plate, then returned to the transport medium and stored at -20 degrees C for several months. After the samples were thawed at room temperature, the SD Bioline Strep A RAT (SD, Korea) was performed. RESULTS: The sensitivity, specificity, positive predictive value, and negative predictive value of SD Bioline Strep A compared with throat culture were 95.9% (95% confidence interval [CI]: 93.6-98.2%), 91.8% (95% CI: 88.5-95.1%), 95.9% (95% CI: 93.6-98.2%), and 91.8% (95% CI: 88.5-95.1%), respectively. CONCLUSIONS: The SD Bioline Strep A RAT kit can be useful as an alternative to throat cultures in the clinics for rapid diagnosis of GAS pharyngitis and for an early decision on the use of antibiotics.
Acute Disease ; Antigens/analysis/immunology ; Child ; Female ; Hospitals, Pediatric ; Humans ; Male ; Pharyngitis/*diagnosis ; Reagent Kits, Diagnostic ; Sensitivity and Specificity ; Streptococcus pyogenes/*isolation & purification

We describe the first case of primary peritonitis in Korea of a healthy person due to Streptococcus pyogenes. In the absence of comorbid conditions, such as liver cirrhosis, immunosuppression, or nephrotic syndrome, primary peritonitis is uncommon in a young healthy woman. Abdomen computed tomography revealed ascites in the lower abdomen and peritoneal enhancement suggesting peritonitis. In diagnostic laparoscopy, purulent ascites was found in the pelvic cavity but both ovaries and fallopian tubes were intact. There were no intra-abdominal abnormalities such as bowel perforation, appendicitis, or necrosis. The reports of blood culture, ascites culture, and cervical swab culture confirmed S. pyogenes. After use of antibiotics, the patient was cured and discharged without sequelae.
Adult ; Anti-Bacterial Agents/therapeutic use ; Female ; Humans ; Laparoscopy ; Peritonitis/*diagnosis/drug therapy/microbiology ; Streptococcal Infections/*diagnosis/drug therapy/microbiology ; Streptococcus pyogenes/*isolation & purification ; Tomography, X-Ray Computed

Anti-Bacterial Agents ; Child ; China ; epidemiology ; Drug Resistance, Bacterial ; genetics ; Erythromycin ; Humans ; Molecular Epidemiology ; Streptococcus pyogenes ; genetics ; isolation & purification ; pathogenicity ; Virulence Factors ; genetics

OBJECTIVETo understand the distribution of emm gene types related to group A streptococcus-caused scarlet fever among children in Beijing and to analyze the relationship between the mutation of the emm types and scarlet fever.

METHODSNasopharyngeal swab samples were collected from the scarlet fever cases diagnosed in 36 hospitals in Beijing to isolate the GAS strains from May to July, betgween 2011 and 2014. Genotyping of emm gene was performed with PCR and N-terminal gene fragments of M protein were sequenced. Data of all the scarlet fever cases in Beijing that reported through the National Notifiable Infectious Disease Surveillance System (NNIDSS) , were gathered and analyzed.

RESULTSAmong the collected 2 161 nasopharyngeal swabs, 762 GAS strains were identified (35.3%). In addition, 7 emm types were detected, in which emm12 accounted for 69.4% (529/762) , emm1 accounted for 29.8% (227/762) , and other five types (emm 11, 22, 75, 89, and 128) accounted for 0.8% (6/762) , respctively. Compared with the emm types detected between 2011 and 2014, emm12, emm1 and other types accounted for 82.2% (295/359) , 16.7% (60/359) and 1.1% (4/359, including emm11, 22 and 89) in 2011 respectively.emm12, emm1 and emm75 accounted for 77.3% (123/163) , 23.9% (39/163) and 0.6% (1/163) respectively in 2012. emm12 and emm1 accounted for 50.7% (38/75) and 49.3% (37/75) in 2013 while emm12, emm1 and emm128 accounted for 44.2% (73/165) , 55.2% (91/165) and 0.6% (1/165) respectively in 2014. The differences of the constitution of emm types from 2011 to 2014 appeared statistically significant (P<0.001). In 2011 and 2012, major type appeared as emm12, but in 2014, emm1 became predominant. A total of 6 152 cases were reported in 2011, while 2 908, 2 048 and 3 918 cases were reported in 2012, 2013 and 2014 respectively. Age specific differences were noticed in the distribution of emm types GAS strains in 2011, with the number of emm12 strains detected higher in 1-5 year olds than in age group > 5 years (P<0.05). There were area specific differences in distribution of emm types of GAS strains seen in 2011 and 2013. In 2011, the number of emm1 strains detected in urban area was higher than in suburb area (P<0.05). However, in 2013, the number of emm1 strains detected in suburb area was seen higher than in urban area (P< 0.05).

CONCLUSIONGAS with emm12 and GAS emm1 appeared interchangeably predominant in Beijing from 2011 to 2014. Changes in predominant emm types seemed also related to the trends of incidence rates on scarlet fever.

Antigens, Bacterial ; Bacterial Outer Membrane Proteins ; Beijing ; epidemiology ; Carrier Proteins ; Child ; Genotype ; Humans ; Mutation ; Scarlet Fever ; epidemiology ; genetics ; Streptococcus pyogenes ; classification ; genetics ; isolation & purification

OBJECTIVETo describe the molecular characteristics of group A Streptococcus (GAS) isolated from patients and asymptomatic carriers of scarlet fever in Shandong province, 2013, and to explore the relationships between emm types and other molecular types.

METHODS72 strains of GAS were isolated from throat swabs of children with scarlet fever or asymptomatic carriers of GAS. All the strains were typed by emm typing, multilocus sequence typing (MLST), super-antigen (SAg) genes detections and pulsed-field gel electrophoreses (PFGE).

RESULTSAmong the 72 strains, emm1 (41.67%) and emm12 (56.94%) were the most common emm types. Two ST types were found, including ST28 (43.06%) and ST36 (56.94%). Additionally, emm1 was also found correlated to ST28, while emm12 was associated with ST36. Eight super-antigen genes were detected, including smeZ (100.00%), ssa (100.00%), speG (97.22%), speC (95.83%), speL (54.17%), speJ (41.67%), speA (38.89%) and speH (38.89%), while speK, speM, speL were not found (0%). Both speA and speJ genes were detected primarily in emm1 strains (all P < 0.05), while speH and speI genes were not detected in emm 1 strains (all P < 0.05). And emm12 strains were inclined to harbor speH and speL (all P < 0.05) but not speA or speJ (all P < 0.05). Twenty different genotypes were identified by PFGE.

CONCLUSIONAll the emm types of GAS isolated from scarlet fever patients and asymptomatic carriers in Shandong province 2013 were mainly emm1 and emm12 and carrying speC, speG and smeZ, ssa. ST types mainly exsited in ST28 and ST36. In addition, there were correlations between emm types and super-antigen genes, ST types, PFGE types.

Antigens, Bacterial ; Bacterial Proteins ; Child ; Electrophoresis, Gel, Pulsed-Field ; Exotoxins ; Genotype ; Humans ; Membrane Proteins ; Multilocus Sequence Typing ; Scarlet Fever ; microbiology ; Streptococcus pyogenes ; genetics ; isolation & purification