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中国北京 COVID-19 大流行期间儿童 A 组链球菌感染性疾病的流行病学分析。

Epidemiological analysis of Group A streptococcus infection diseases among children in Beijing, China under COVID-19 pandemic.

机构信息

Department of Dermatology, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing, 100020, China.

Department of Clinical Laboratory, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing, 100020, China.

出版信息

BMC Pediatr. 2023 Feb 13;23(1):76. doi: 10.1186/s12887-023-03885-7.

Abstract

BACKGROUND

Group A streptococcus is human-restricted gram-positive pathogen, responsible for various clinical presentations from mild epidermis infections to life threatened invasive diseases. Under COVID-19 pandemic,. the characteristics of the epidemic strains of GAS could be different.

PURPOSE

To investigate epidemiological and molecular features of isolates from GAS infections among children in Beijing, China between January 2020 and December 2021. Antimicrobial susceptibility profiling was performed based on Cinical Laboratory Sandards Institute. Distribution of macrolide-resistance genes, emm types, and superantigens was examined by polymerase chain reaction.

RESULTS

114 GAS isolates were collected which were frequent resistance against erythromycin (94.74%), followed by clindamycin (92.98%), tetracycline (87.72%). Emm12 (46.49%), emm1 (25.44%) were dominant emm types. Distribution of ermB, ermA, and mefA gene was 93.85%, 2.63%, and 14.04%, respectively. Frequent superantigenes identified were smeZ (97.39%), speG (95.65%), and speC (92.17%). Emm1 strains possessed smeZ, ssa, and speC, while emm12 possessed smeZ, ssa, speG, and speC. Erythromycin resistance was predominantly mediated by ermB. Scarlet fever strains harbored smeZ (98.81%), speC (94.05%). Impetigo strains harbored smeZ (88.98%), ssa (88.89%), and speC (88.89%). Psoriasis strains harbored smeZ (100%).

CONCLUSIONS

Under COVID-19 pandemic, our collections of GAS infection cutaneous diseases decreased dramatically. Epidemiological analysis of GAS infections among children during COVID-19 pandemic was not significantly different from our previous study. There was a correlation among emm, superantigen gene and disease manifestations. Long-term surveillance and investigation of emm types and superantigens of GAS prevalence are imperative.

摘要

背景

A 组链球菌是一种局限于人类的革兰阳性病原体,可引起从轻度表皮感染到危及生命的侵袭性疾病等多种临床表现。在 COVID-19 大流行期间,A 组链球菌流行株的特征可能有所不同。

目的

研究 2020 年 1 月至 2021 年 12 月期间中国北京儿童 A 组链球菌感染的流行病学和分子特征。根据临床实验室标准协会(Clinical Laboratory Standards Institute)进行抗生素药敏性分析。通过聚合酶链反应(polymerase chain reaction)检测大环内酯类耐药基因、emm 型和超抗原的分布。

结果

共收集了 114 株 A 组链球菌,对红霉素(94.74%)、克林霉素(92.98%)和四环素(87.72%)的耐药性较高。emm12(46.49%)和 emm1(25.44%)是主要的 emm 型。ermB、ermA 和 mefA 基因的分布分别为 93.85%、2.63%和 14.04%。常见的超抗原为 smeZ(97.39%)、speG(95.65%)和 speC(92.17%)。emm1 菌株携带 smeZ、ssa 和 speC,而 emm12 菌株携带 smeZ、ssa、speG 和 speC。红霉素耐药主要由 ermB 介导。猩红热菌株携带 smeZ(98.81%)和 speC(94.05%)。脓疱疮菌株携带 smeZ(88.98%)、ssa(88.89%)和 speC(88.89%)。银屑病菌株携带 smeZ(100%)。

结论

在 COVID-19 大流行期间,我们收集的 A 组链球菌感染性皮肤病数量显著减少。COVID-19 大流行期间儿童 A 组链球菌感染的流行病学分析与我们之前的研究无显著差异。emm、超抗原基因与疾病表现之间存在相关性。长期监测和调查 A 组链球菌流行株的 emm 型和超抗原至关重要。

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