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Journal of Clinical Microbiology, July 2007, p. 2249-2256, Vol. 45, No. 7
0095-1137/07/$08.00+0     doi:10.1128/JCM.00513-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

emm Types, Virulence Factors, and Antibiotic Resistance of Invasive Streptococcus pyogenes Isolates from Italy: What Has Changed in 11 Years?{triangledown}

Roberta Creti,* Monica Imperi, Lucilla Baldassarri, Marco Pataracchia, Simona Recchia, Giovanna Alfarone, and Graziella Orefici

Dipartimento di Malattie Infettive, Parassitarie ed Immunomediate, Istituto Superiore di Sanità, Rome, Italy

Received 7 March 2007/ Returned for modification 12 April 2007/ Accepted 27 April 2007

To investigate the epidemiology and characteristics of invasive group A streptococcal (GAS) disease over 11 years in Italy, this study compared the emm types and the superantigen toxin genes speA and speC as well as the erythromycin, clindamycin, and tetracycline susceptibilities of 207 invasive GAS strains collected during two national enhanced surveillance periods (1994 to 1996 and 2003 to 2005) and the time between each set of surveillance periods. The present study demonstrated that emm1 strains were consistently responsible for about 20% of invasive GAS infections, while variations in the frequencies of the other types were noted, although the causes of most cases of invasive infections were restricted to emm1, emm3, emm4, emm6, emm12, and emm18. During the 1994 to 1996 surveillance period, an emm89 epidemic clone spread across the northern part of Italy. A restricted macrolide resistance phenotype-type distribution of the bacteriophage-encoded speA toxin as well as of macrolide resistance genes was noted over time. Indeed, the recent acquisition of macrolide resistance in previously susceptible emm types was observed.

* Corresponding author. Mailing address: Reparto di Malattie Batteriche Respiratorie e Sistemiche, Dipartimento di Malattie Infettive, Parassitarie ed Immunomediate, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161 Rome, Italy. Phone: 39-06-49902116. Fax: 39-06-49902886. E-mail: roberta.creti{at}iss.it

{triangledown} Published ahead of print on 9 May 2007.

Journal of Clinical Microbiology, July 2007, p. 2249-2256, Vol. 45, No. 7
0095-1137/07/$08.00+0     doi:10.1128/JCM.00513-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.



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