Erdem Guliz, Mizumoto Carla, Esaki David, Abe Lucienne, Reddy Venu, Effler Paul V
Department of Pediatrics, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii.
Pediatr Infect Dis J. 2009 Jan;28(1):13-6. doi: 10.1097/INF.0b013e31818128ce.
The clinical epidemiology of group A streptococcal (GAS) infections in Hawaii seems different from that in the continental United States with frequent skin infections and endemically high rates of acute rheumatic fever (ARF).
GAS emm types in Hawaii were determined to identify any possible association between the emm types and specific clinical manifestations. A convenience sample of 1482 Hawaii GAS isolates collected between February 2000 and December 2005 was used. All isolates were characterized by emm sequence typing. The distribution of emm types in Hawaii was compared with the published continental US data for pharyngeal and invasive GAS strains, the CDC database from similar time periods, as well as with emm types present in a candidate GAS vaccine.
Ninety-three distinct emm types were recognized among the 1482 GAS isolates. The most frequently identified emm types in order of decreasing frequency were 12, 1, 28, 4, 22, 77, 81, 58, 65/69, 49, 74, 85, 92, 75, 101 and 2. Of this study sample, 27 of the 50 invasive GAS isolates belonged to uncommon continental US emm types (54% in Hawaii cultures vs. 10% reported from the continental US). Of the 1179 pharyngeal isolates, 509 belonged uncommon continental US emm types (43% in Hawaii cultures vs. 27% reported from the continental US).
The prevalent emm types in Hawaii differ from those in the continental US. The prevalence of these unusual emm types might limit the effectiveness of any proposed multivalent type-specific GAS vaccine in Hawaii.
夏威夷A组链球菌（GAS）感染的临床流行病学似乎与美国大陆不同，皮肤感染频繁且急性风湿热（ARF）的地方流行率很高。
确定夏威夷的GAS emm型，以确定emm型与特定临床表现之间的任何可能关联。使用了2000年2月至2005年12月期间收集的1482株夏威夷GAS分离株的便利样本。所有分离株均通过emm序列分型进行鉴定。将夏威夷的emm型分布与已发表的美国大陆咽和侵袭性GAS菌株数据、同期的疾病控制与预防中心数据库以及候选GAS疫苗中存在的emm型进行比较。
在1482株GAS分离株中识别出93种不同的emm型。按频率递减顺序最常鉴定出的emm型为12、1、28、4、22、77、81、58、65/69、49、74、85、92、75、101和2。在本研究样本中，50株侵袭性GAS分离株中有27株属于美国大陆不常见的emm型（夏威夷培养物中为54%，而美国大陆报告为10%）。在1179株咽部分离株中，509株属于美国大陆不常见的emm型（夏威夷培养物中为43%，而美国大陆报告为27%）。
夏威夷流行的emm型与美国大陆不同。这些不寻常的emm型的流行可能会限制任何提议的多价型特异性GAS疫苗在夏威夷的有效性。
