Halperin T, Levine H, Korenman Z, Burstein S, Amber R, Sela T, Valinsky L
Israel Defense Forces Medical Corps, Tel HaShomer, Israel.
Hebrew University-Hadassah Braun School of Public Health and Community Medicine, Jerusalem, Israel.
Eur J Clin Microbiol Infect Dis. 2016 Oct;35(10):1649-54. doi: 10.1007/s10096-016-2705-x. Epub 2016 Jun 21.
Beta-hemolytic group G streptococci (GGS) are increasingly recognized as a source of substantial morbidity, causing mild to severe sporadic infections as well as outbreaks. The purpose of this study was to determine the genetic diversity and antibiotic resistance of GGS in Israel in order to aid in prevention and control. A total of 325 GGS isolates were collected in Israel between 2007 and 2011 from three determined settings: (1) carriage (n = 60), an observational longitudinal carriage study in the IF, (2) non-invasive (n = 166), clinical sporadic and epidemic non-invasive cases in the IDF, and (3) invasive (n = 99) cases of bacteremia collected during this period in Israel from a similar age group, at the national Streptococcal Reference Center. All isolates were characterized genetically and by their antibiotic-resistance profile. emm typing revealed 35 distinct types and subtypes among 228 S. dysgalactiae subsp. equisimilis (SDSE) isolates, with high genetic diversity. An additional 97 GGS were identified as Streptococcus anginosus (SAG). The proportion of SDSE was higher in the invasive (100 %) and non-invasive (63.8 %) isolates compared to the carriage ones (38.3 %). Clindamycin, erythromycin, azithromycin and tetracycline resistance was detected in 6.6 %, 8.6 %, 9.7 % and 37.6 % of isolates, respectively. Overall, the most resistant isolates were in the invasive group and the fewest were in the SAG group. Considerable genetic diversity and common antibiotic resistance were revealed among GGS strains which differed according to the epidemiologic settings. Further clinical, epidemiological and basic research of GGS as a pathogen is warranted.
β溶血性G群链球菌（GGS）日益被认为是严重发病的一个来源，可引起轻度至重度的散发性感染以及暴发。本研究的目的是确定以色列GGS的遗传多样性和抗生素耐药性，以协助预防和控制。2007年至2011年期间，在以色列从三个特定环境中收集了总共325株GGS分离株：（1）携带（n = 60），在以色列国防军进行的一项关于携带情况的观察性纵向研究；（2）非侵袭性（n = 166），以色列国防军中临床散发性和流行性非侵袭性病例；（3）侵袭性（n = 99），在此期间从以色列一个类似年龄组的全国链球菌参考中心收集的菌血症病例。所有分离株均进行了基因特征分析和抗生素耐药性分析。emm分型显示，在228株马链球菌兽疫亚种（SDSE）分离株中存在35种不同的类型和亚型，具有高度的遗传多样性。另外97株GGS被鉴定为咽峡炎链球菌（SAG）。与携带菌株（38.3%）相比，侵袭性菌株（100%）和非侵袭性菌株（63.8%）中SDSE的比例更高。分别在6.6%、8.6%、9.7%和37.6%的分离株中检测到对克林霉素、红霉素、阿奇霉素和四环素的耐药性。总体而言，耐药性最强的分离株在侵袭性组，最少的在SAG组。GGS菌株之间存在相当大的遗传多样性和常见的抗生素耐药性，且根据流行病学环境而有所不同。有必要对作为病原体的GGS进行进一步的临床、流行病学和基础研究。
