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J. Clin. Microbiol. doi:10.1128/JCM.00513-07
Copyright (c) 2007, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights Reserved.

Emm types, virulence factors and antibiotic resistance of invasive S. pyogenes isolates from Italy: what has changed in eleven years?

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

^* To whom correspondence should be addressed. Email: roberta.creti{at}iss.it.

	Abstract

To investigate the epidemiology and characteristics of invasive GAS disease in eleven years in our country, this study compared the emm types, the superantigen toxin genes speA and speC as well as erythromycin, clindamycin and tetracycline susceptibility of 207 invasive GAS strains collected from two national enhanced surveillance periods (1994-1996; 2003-2005) and in the period within.

The present study demonstrated that emm1 strains were constantly responsible of about 20% of invasive GAS infections while variation in frequency was noted for other types although most cases of invasive infections were restricted to emm1, emm3, emm4, emm6, emm12 and emm18. During the surveillance period 1994-1996 an emm89 epidemic clone spread across the Northern part of Italy.

A restricted M-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 has been observed.

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