Abstract

Fluctuations in the clonal composition of Group A Streptococcus (GAS) have been associated with the emergence of successful lineages and with upsurges of invasive infections (iGAS). This study aimed at identifying changes in the clones causing iGAS in Portugal. Antimicrobial susceptibility testing, emm typing and superantigen (SAg) gene profiling were performed for 381 iGAS isolates from 2010–2015. Macrolide resistance decreased to 4%, accompanied by the disappearance of the M phenotype and an increase of the iMLSB phenotype. The dominant emm types were: emm1 (28%), emm89 (11%), emm3 (9%), emm12 (8%), and emm6 (7%). There were no significant changes in the prevalence of individual emm types, emm clusters, or SAg profiles when comparing to 2006–2009, although an overall increasing trend was recorded during 2000–2015 for emm1, emm75, and emm87. Short-term increases in the prevalence of emm3, emm6, and emm75 may have been driven by concomitant SAg profile changes observed within these emm types, or reflect the emergence of novel genomic variants of the same emm types carrying different SAgs.

Details

Title
Changes in emm types and superantigen gene content of Streptococcus pyogenes causing invasive infections in Portugal
Author
Friães, A 1   VIAFID ORCID Logo  ; Melo-Cristino, J 1 ; Ramirez, M 1   VIAFID ORCID Logo  ; Vaz, Teresa 2 ; Gião, Marília 2 ; Ferreira, Rui 2 ; Fonseca, Ana Buschy 3 ; Oliveira, Henrique 4 ; Silva, Ana Cristina 5 ; Costa, Hermínia 5 ; Pinto, Margarida 6 ; Chantre, Odete 6 ; Marques, João 6 ; Peres, Isabel 6 ; Daniel, Isabel 6 ; Canas, Ema 6 ; Ferreira, Teresa 6 ; Marcelo, Cristina 6 ; Monteiro, Lurdes 7 ; Luís Marques Lito 7 ; Marques, Teresa 8 ; Martins, Filomena 8 ; Pessanha, Maria Ana 8 ; Gonçalves, Elsa 8 ; Morais, Teresa 8 ; Lopes, Paulo 9 ; Felício, Luísa 9 ; Lameirão, Angelina 9 ; Ana Paula Mota Vieira 10 ; Tomaz, Margarida 10 ; Bento, Rosa 11 ; Ramos, Maria Helena 12 ; Ana Paula Castro 12 ; Fonseca, Fernando 13 ; Ribeiro, Graça 14 ; Tomé, Rui 14 ; Pontes, Celeste 14 ; Boaventura, Luísa 14 ; Canhoto, Nuno 15 ; Afonso, Teresa 15 ; Pina, Teresa 16 ; Peres, Helena 16 ; Fontes, Ilse 17 ; Martinho, Paulo 17 ; Domingos, Ana 18 ; Marrão, Gina 18 ; Grossinho, José 18 ; Ribeiro, Manuela 19 ; Faustino, Alberta 20 ; Alves, Adelaide 20 ; Maria Paula Pinheiro 21 ; Semedo, R 21 ; Coutinho, Adriana 22 ; Cabral, Luísa 23 ; Neto, Olga 23 ; Sancho, Luísa 24 ; Diogo, José 25 ; Rodrigues, Ana 25 ; Nascimento, Isabel 25 ; Ramalheira, Elmano 26 ; Bessa, Fernanda 26 ; Marques, I 27 ; José Miguel Ribeiro 27 ; Read, Maria Antónia 28 ; Alves, Valquíria 28 ; Raposo, Engrácia 29 ; Maria Lurdes Magalhães 29 ; Rochas, Helena 29 ; Silva, Anabela 29 ; Rodrigues, Margarida 30 ; Maria Favila Meneses 31 ; José Germano de Sousa 31 ; Mariana Bettencourt Viana 32 ; Terra, Isaura 32 ; Rodrigues, Vitória 33 ; Pereira, Patrícia 33 ; Duarte, Jesuína 34 ; Pinto, Paula 35 ; Moreira, Ezequiel 36 ; Ferreira, João Ataíde 37 ; Adília Vicente 38 ; Paixão, Paulo 39 ; Novais, Natália 40 

1  Instituto de Microbiologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal 
2  Centro Hospitalar do Barlavento Algarvio, Portimão, Portugal 
3  Hospital de Cascais, Cascais, Portugal 
4  Centro Hospitalar de Coimbra, Coimbra, Portugal 
5  Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, Portugal 
6  Centro Hospitalar de Lisboa Central, Lisboa, Portugal 
7  Centro Hospitalar Lisboa Norte, Lisboa, Portugal 
8  Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal 
9  Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal 
10  Centro Hospitalar do Alto Ave, Guimarães, Portugal 
11  Centro Hospitalar do Baixo Alentejo, Beja, Portugal 
12  Centro Hospitalar do Porto, Porto, Portugal 
13  Centro Hospitalar da Póvoa de Varzim/Vila do Conde, Póvoa de Varzim, Portugal 
14  Hospitais da Universidade de Coimbra, Coimbra, Portugal 
15  Centro Hospitalar do Funchal, Funchal, Portugal 
16  Hospital Curry Cabral, Lisboa, Portugal 
17  Hospital de Santa Luzia, Elvas, Portugal 
18  Hospital de Santo André, Leiria, Portugal 
19  Hospital de São João, Porto, Portugal 
20  Hospital de Braga, Braga, Portugal 
21  Hospital Dr. José Maria Grande, Portalegre, Portugal 
22  Hospital do Espírito Santo, Évora, Portugal 
23  Hospital dos SAMS, Lisboa, Portugal 
24  Hospital Prof. Doutor Fernando da Fonseca, Amadora, Portugal 
25  Hospital Garcia de Orta, Almada, Portugal 
26  Hospital Infante D. Pedro, Aveiro, Portugal 
27  Hospital de São Teotónio, Viseu, Portugal 
28  Hospital Pedro Hispano, Matosinhos, Portugal 
29  Instituto Nacional de Saúde Ricardo Jorge, Porto, Portugal 
30  Hospital Reynaldo dos Santos, Vila Franca de Xira, Portugal 
31  Hospital CUF Descobertas, Lisboa, Portugal 
32  Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal 
33  Hospital Beatriz Ângelo, Loures, Portugal 
34  Centro Hospitalar de Setúbal, Setúbal, Portugal 
35  Hospital Distrital de Santarém, Santarém, Portugal 
36  Centro Hospitalar do Médio Ave, Santo Tirso, Portugal 
37  Hospital de Faro, Faro, Portugal 
38  Centro Hospitalar do Oeste Norte, Caldas da Raínha, Portugal 
39  Hospital da Luz, Lisboa, Portugal 
40  Hospital da Figueira da Foz, Figueira da Foz, Portugal 
Pages
1-10
Publication year
2019
Publication date
Dec 2019
Publisher
Nature Publishing Group
e-ISSN
20452322
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1038/s41598-019-54409-2
ProQuest document ID
2321205738
Copyright
© 2019. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.