Department of Laboratory Medicine, Gyeongsang National University College of Medicine, Jinju, Korea.
Department of Laboratory Medicine, Chonbuk National University School of Medicine, Jeonju, Korea.
Ann Lab Med. 2018 May;38(3):212-219. doi: 10.3343/alm.2018.38.3.212.
The molecular characterization of Streptococcus dysgalactiae subsp. equisimilis (SDSE) has not yet been performed in Korea. This study aimed to find the differences or similarities in the clinical features, molecular epidemiological findings, and antimicrobial resistance patterns of SDSE from two countries (Korea and Japan).
SDSE isolates were collected from Korea (N=69) from 2012-2016 and Japan (N=71) from 2014-2016. Clinical characteristics, emm genotypes, and sequence types (STs) were compared. Microdilution tests were performed using different antimicrobials, and their resistance determinants were screened.
Median ages were 69 years in Korea and 76 years in Japan. The most common underlying diseases were diabetes and malignancy. Blood-derived isolates comprised 36.2% and 50.7% of Korean and Japanese isolates, respectively; mortality was not different between the two groups (5.8% vs 9.9%, P=0.53). Among Korean isolates with 20 different combined ST-emm types, ST127-stG245 (N=16), ST128-stG485 (N=10), and ST138-stG652 (N=8) were prevalent. Among Japanese isolates with 29 different combined types, ST17-stG6792 (N=11), ST29-stG485 (N=7), and ST205-stG6792 (N=6) were prevalent. Resistance rates to erythromycin, clindamycin, and minocycline were 34.8%, 17.4%, and 30.4% in Korea and 28.2%, 14.1%, and 21.4% in Japan, respectively.
SDSE infections commonly occurred in elderly persons with underlying diseases. There was a significant difference in the distribution of ST-emm types between the two countries. Antimicrobial resistance rates were comparable with different frequencies of resistance determinants in each country.
目前尚未在韩国对无乳链球菌似马亚种（SDSE）进行分子特征分析。本研究旨在比较来自两个国家（韩国和日本）的 SDSE 在临床特征、分子流行病学和抗菌药物耐药模式方面的异同。
收集了 2012 年至 2016 年期间来自韩国（69 株）和 2014 年至 2016 年期间来自日本（71 株）的 SDSE 分离株。比较了临床特征、emm 基因型和序列型（ST）。采用微量稀释法对不同抗菌药物进行药敏试验，并筛选其耐药决定因子。
韩国患者的中位年龄为 69 岁，日本患者的中位年龄为 76 岁。最常见的基础疾病为糖尿病和恶性肿瘤。血液来源的分离株分别占韩国和日本分离株的 36.2%和 50.7%；两组死亡率无差异（5.8% vs 9.9%，P=0.53）。在韩国的 20 种不同的 ST-emm 组合型中，ST127-stG245（16 株）、ST128-stG485（10 株）和 ST138-stG652（8 株）最为常见。在日本的 29 种不同的 ST-emm 组合型中，ST17-stG6792（11 株）、ST29-stG485（7 株）和 ST205-stG6792（6 株）最为常见。韩国分离株对红霉素、克林霉素和米诺环素的耐药率分别为 34.8%、17.4%和 30.4%，日本分离株的耐药率分别为 28.2%、14.1%和 21.4%。
SDSE 感染常见于患有基础疾病的老年人群。两个国家的 ST-emm 型分布存在显著差异。两国的抗菌药物耐药率相近，但耐药决定因子的出现频率不同。
