Molecular Characterization of Streptococcus pyogenes Causing Invasive Disease in Pediatric Population in Spain A 12-year Study.

OBJECTIVES: To perform a comprehensive description of the epidemiology of Streptococcus pyogenes invasive disease in the pediatric population in 2 regions of Spain (Catalonia and Gipuzkoa) through 12 years. METHODS: All S. pyogenes isolates causing invasive disease in pediatric patients between 2005 and 2016 were included. The emm-type and the presence of 13 exotoxin genes (speA, speB, speC, speF, speG, speH, speI, speJ, speK, speL, speM, smeZ, ssa and slo) were determined in all 93 available isolates and the Multi Locus Sequece Typing in 10% of isolates of each different emm-type. RESULTS: Overall, 103 cases of S. pyogenes invasive infections were detected: 77 in Catalonia and 26 in Gipuzkoa, being 50.5% females. The incidence rate per 100,000 children was 2.5 for Gipuzkoa and 2.6 for Catalonia, with no significant temporal trends. The median age was 30 months. The most frequent clinical presentations were: pneumonia (26.2%), bacteremia/sepsis (23.3%), septic arthritis/osteomyelitis (22.3%), cellulitis/mastoiditis (12.6%) and meningitis (6.8%). Eight children developed streptococcal toxic shock syndrome. Nine cases were preceded by varicella infection. The associated mortality rate was 3.9%. Three isolates were resistant to erythromycin, being one of them also resistant to clindamycin and 4 isolates were resistant to levofloxacine. Forteen different emm-types were detected being emm1/ST28 (40.9%) the most frequent clone in both regions followed by emm12/ST36-ST242, emm6/ST382, emm3/ST15, emm75/ST150 and emm4/ST38-39. speA gene was only detected in emm1 and emm3 isolates. Eight exotoxins were enough to assign an emm-type with a very high degree of accuracy (95%). The 30-valent vaccine would include 96.8% of isolates.

Septic arthritis caused by Staphylococcus caprae following arthroscopic meniscus tear repair in a patient without any foreign device / Artritis séptica causada por Staphylococcus caprae tras reparación artroscópica de menisco en paciente sin material protésico

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Isolation and Characterization of Actinobacteria from Algerian Sahara Soils with Antimicrobial Activities.

Extreme ecosystems can be a source of untapped microorganisms to produce novel bioactive compounds of industrial interest. Consequently, in this work, 32 actinomycetes were isolated from 6 soil samples collected from Algerian Sahara in searching for untapped producers of novel antimicrobial compounds. All the isolates were further subjected to antimicrobial screening against pathogenic bacteria, yeast and fungi. The obtained results indicated that three of the isolates (named C, MS1 and 10) showed antimicrobial activities against most of the tested pathogenic microorganisms. Therefore, these three promising isolates, previously identified as Streptomyces by morphological, biochemical and physiological methods, were selected for their subsequent identification by the whole cell matrix assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS) analysis. Thus, the isolates C, MS1 and 10 were identified as Streptomyces violaceoruber B263 UFL, Streptomyces albus B262 UFL and Streptomyces badius B192 UFL, respectively. These results pointed out actinomycetes from Sahara soils as potential sources of novel antimicrobial compounds. Also, MALDI-TOF MS showed to be a robust technique for bacteria identification.

Streptococcus pyogenes emm-types in northern Spain; population dynamics over a 7-year period.

OBJECTIVE: To know the clinical entities caused by Streptococcus pyogenes as well as the characteristics of the isolates involved in them throughout a 7-year-study. METHODS: All S. pyogenes infectious episodes from the community recorded in the reference hospital of Gipuzkoa between 2005 and 2011 were included (n = 11,342). A random selection of 10% of total isolates was characterized by emm-type, T-type and multilocus-sequence-type. RESULTS: Main clinical presentations were: pharyngitis (n = 9467), otitis (n = 797), dermal infections (n = 506), and genital infections (n = 374). Highest frequency of pharyngitis and otitis was detected in children aged 2-8 years old and 1-year old, respectively. Among 29 emm-types, 8 (emm4, emm89, emm3, emm87, emm1, emm12, emm6 and emm75) grouped >70% of isolates. emm4 was significantly associated with 0-4 year-old patients, and emm89 and emm77 with patients >64 years; by infection type, emm4, emm87 and emm12 were associated with pharyngitis, emm1 and emm6 with otitis, emm89 with dermal infections, and emm77 with genital infections. CONCLUSIONS: Predominant emm-type changed every year, although the diversity was similar throughout the study period. S. pyogenes pharyngitis maximum incidence presented at earlier age than expected. emm-type associations with age and specific clinical presentations were influenced by population immunity and strain tropism.

Género Streptococcus: una revisión práctica para el laboratorio de microbiología / The Streptococcus genus: a practical review for the microbiology laboratory

El género Streptococcus es un grupo muy numeroso y heterogéneo de bacterias, algunas de las cuales son importantes patógenos para el ser humano. En el presente artículo revisaremos la nomenclatura, la clasificación y los métodos para identificar a las distintas especies del género Streptococcus, desde el punto de vista del trabajo habitual en un laboratorio de microbiología clínica. Las especies de estreptococos más frecuentemente patógenas en humanos (cepas betahemolíticas y Streptococcus pneumoniae) pueden identificarse fácilmente usando unas pocas pruebas fenotípicas y bioquímicas. Algunas especies, en cambio, son difíciles de identificar, incluso mediante técnicas moleculares basadas en el análisis del gen 16SrRNA

The Streptococcus genus consists of a numerous and heterogeneous group of bacteria, some of which are important human pathogens. The present article reviews the current nomenclature and classification of the distinct species of the Streptococcus genus, as well as the methods used for their identification in the routine activity of clinical microbiology laboratories. The most frequent Streptococcus species acting as human pathogens (betahemolytic strains and Streptococcus pneumoniae) can be easily identified by using a few phenotypic and biochemical tests. However, some Streptococcus strains are difficult to identify, even using molecular techniques based on analysis of the 16S rRNA gene

New mutations and horizontal transfer of rpoB among rifampin-resistant Streptococcus pneumoniae from four Spanish hospitals.

A total of 103 (0.7%) of 14,236 Streptococcus pneumoniae isolates collected in four Spanish hospitals from 1989 to 2003 were resistant to rifampin (MICs, 4 to 512 microg/ml). Only sixty-one (59.2%) of these isolates were available for molecular characterization. Resistance was mostly related to human immunodeficiency virus (HIV) infection in adult patients and to conjunctivitis in children. Thirty-six different pulsed-field gel electrophoresis patterns were identified among resistant isolates, five of which were related to international clones (Spain23F-1, Spain6B-2, Spain9V-3, Spain14-5, and clone C of serotype 19F), and accounted for 49.2% of resistant isolates. Single sense mutations at cluster N or I of the rpoB gene were found in 39 isolates, while double mutations, either at cluster I, at clusters I and II, or at clusters N and III, were found in 14 isolates. The involvement of the mutations in rifampin resistance was confirmed by genetic transformation. Single mutations at clusters N and I conferred MICs of 2 microg/ml and 4 to 32 microg/ml, respectively. Eight isolates showed high degrees of nucleotide sequence variations (2.3 to 10.8%) in rpoB, suggesting a recombinational origin for these isolates, for which viridans group streptococci are their potential gene donors. Although the majority of rifampin-resistant isolates were isolated from individual patients without temporal or geographical relationships, the clonal dissemination of rifampin-resistant isolates was observed among 12 HIV-infected patients in the two hospitals with higher rates of resistance.

Spectrum of antibiotic resistance of the Spain14-5 Streptococcus pneumoniae clone over a 22 year period.

OBJECTIVE: To study the characteristics and the evolution through time of a single Streptococcus pneumoniae multidrug-resistant international clone. METHODS: From 1981 to 2002, the presence of the multidrug-resistant Spain14-5 clone was studied among the 4201 S. pneumoniae isolated in Gipuzkoa (northern Spain). RESULTS: Overall, 93 isolates belonging to the Spain14-5 clone were identified. The first isolate of this clone was detected in 1981 and was already resistant to beta-lactams, erythromycin, clindamycin and chloramphenicol. The reference strain from the international collection for this clone was susceptible to macrolides and lincosamides whereas most of the isolates studied, including the first isolate detected in 1981, were resistant to macrolides and had the erm(B) gene encoding macrolide resistance. CONCLUSIONS: The clone was genetically stable through time, was multiresistant since its inception and has recently become highly resistant to fluoroquinolones. The characteristic antibiotic resistance pattern of this clone should include erythromycin resistance.

Varón de 70 años con tumoración laterocervical izquierda y fiebre / Seventy-year old male patient with left laterocervical tumour and fever. Case report

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