Abstract
Beta-hemolytic streptococci (βHS) cause a diverse array of human infections. Despite the high number of cases of streptococcal carriers and diseases, studies discerning the molecular epidemiology of βHS in India are limited. This study reports the molecular and clinical epidemiology of beta-hemolytic streptococcal infections from two geographically distinct regions of India. A total of 186 isolates of βHS from north and south India were included. The isolates were identified to species level and subjected to antimicrobial susceptibility testing. Polymerase chain reaction (PCR) was done to detect exotoxin genes, and emm types of group A streptococci (GAS) strains were ascertained by sequencing. GAS was the most common isolate (71.5%), followed by group G streptococci (GGS) (21%). A large proportion of GAS produced speB (97%), smeZ (89%), speF (91%), and speG (84%). SmeZ was produced by 21% and 50% of GGS and GGS, respectively. A total of 45 different emm types/subtypes were seen in GAS, with emm 11 being the most common. Resistance to tetracycline (73%) and erythromycin (34.5%) was commonly seen in GAS. A high diversity of emm types was seen in Indian GAS isolates with high macrolide and tetracycline resistance. SpeA was less commonly seen in Indian GAS isolates. There was no association between disease severity and exotoxin gene production.
Highlights
Beta-hemolytic streptococci cause a diverse array of human infections
Group A streptococci (GAS) constitute the most important and prevalent members of this group, causing clinical syndromes ranging from self-limited pharyngitis and impetigo to potentially life-threatening toxic shock syndrome [1]
Large colony phenotypes of GCGS are usually associated with human infections and are classified in the same subspecies, Streptococcus dysgalactiae subsp
Summary
Beta-hemolytic streptococci (βHS) cause a diverse array of human infections. Despite the high number of cases of streptococcal carriers and diseases, studies discerning the molecular epidemiology of βHS in India are limited. In India, compared to the disease burden [6], relatively few studies have been conducted on the overall profile of beta-hemolytic streptococcal infections, the distribution of emm types, and the presence of exotoxins. We conducted this study to ascertain the clinical and molecular epidemiology of streptococcal infections from two geographically distinct areas (north and south) of India.
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