RESUMO
Streptococcal toxic shock syndrome (STSS) is a severe invasive infection characterized by the sudden onset of shock, multiorgan failure, and high mortality. Although STSS is mainly caused by Streptococcus pyogenes, group G streptococcus identified as S. dysgalactiae subsp. equisimilis (SDSE) causing STSS has also been reported; however, no study has analyzed >100 isolates of SDSE causing STSS. Therefore, we characterized the emm genotype of 173 SDSE isolates obtained from STSS patients in Japan during 2014-2016 and performed antimicrobial susceptibility testing using the broth microdilution method and emm gene typing. The predominant emm genotype was found to be stG6792, followed by stG485, stG245, stG10, stG6, and stG2078. These six genotypes constituted more than 75% of the STSS isolates. The proportion of each emm genotype in STSS isolates correlated with that in invasive isolates previously reported. We found that 16.2% of the isolates showed clindamycin resistance. The proportion of clindamycin-resistant SDSE isolates was significantly higher than that of S. pyogenes isolates. Thus, while treating STSS caused by SDSE, it is necessary to consider the possibility of clindamycin resistance and to ensure judicious use of the drug.
Assuntos
Farmacorresistência Bacteriana , Choque Séptico/microbiologia , Infecções Estreptocócicas/microbiologia , Streptococcus pyogenes , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Antígenos de Bactérias/genética , Proteínas da Membrana Bacteriana Externa/genética , Proteínas de Transporte/genética , Clindamicina/uso terapêutico , Feminino , Técnicas de Genotipagem , Humanos , Japão/epidemiologia , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Choque Séptico/tratamento farmacológico , Choque Séptico/epidemiologia , Infecções Estreptocócicas/tratamento farmacológico , Infecções Estreptocócicas/epidemiologia , Streptococcus pyogenes/classificação , Streptococcus pyogenes/efeitos dos fármacos , Streptococcus pyogenes/genética , Streptococcus pyogenes/isolamento & purificaçãoRESUMO
The 106 methicillin-resistant strains of Staphylococcus aureus (MRSA) isolated in Fukushima Medical College Hospital were examined for their properties and mecA gene. The strains produced four types of coagulase, of which type II was the most common, produced by 84 (79.2%). Beta-lactamase was produced by 58 (50%). Enterotoxins were produced by 45 (42.5%), most of which (39/106, 36.8%) were of type A. Thirty-four strains (32.1%) produced both enterotoxins and toxic shock syndrome toxin-1. All strains were susceptible to vancomycin and arbekacin, although they were mostly resistant to many other antibiotics. Using the polymerase chain reaction (PCR) technique, the mecA gene was detected in 57 (91.9%) of the 62 strains used. In addition, one of the 42 methicillin-susceptible strains isolated had the mecA gene. These results indicate that detection of the mecA gene by the PCR technique is a rapid and accurate way to identify methicillin resistance.
