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Journal of Clinical Microbiology, 06 1996, 1448-1452, Vol 34, No. 6
Copyright © 1996 by the American Society for Microbiology. All rights reserved.

Molecular epidemiology of impetiginous group A streptococcal infections in aboriginal communities of northern Australia

DL Gardiner and KS Sriprakash
Menzies School of Health Research, Darwin, Australia.

Group A streptococcal infections among the Aboriginal communities of the Northern Territory of Australia are endemic, with a concurrently high rate of the postinfection sequelae of rheumatic fever and acute post-streptococcal glomerulonephritis. The majority of the group A streptococcal isolates from the Northern Territory are not typeable by M typing. We recently developed a novel genotyping method, Vir typing. A preliminary study using this method discriminated all the M- nontypeable (MNT) isolates. Vir typing is based on restriction fragment length polymorphisms of the 4- to 7-kb Vir regulon of group A streptococci, which contains a number of genes, including emm (the gene for M protein). A total of 407 isolates of group A streptococci obtained from four Aboriginal communities over a 4-year period were typed by this genotyping method. Forty-two distinct genotypes were found among the isolates, including 22 among the MNT isolates. The correlation between Vir type and M type was good. This genotyping method allows the characterization of all group A streptococcal isolates from Aboriginal communities in the Northern Territory. We also propose that Vir typing be used in conjunction with M typing for epidemiological surveillance in geographical regions where the majority of isolates are MNT.


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