Γενετικά και φαινοτυπικά χαρακτηριστικά στελεχών β-αιμολυτικού στρεπτοκόκκου ομάδας Α απο παιδιά με διεισδυτικές και μη διεισδυτικές λοιμώξεις

Doctoral Dissertation uoadl:1326083 108 Read counter

Unit:
Τομέας Υγείας - Μητέρας - Παιδιού
Library of the School of Health Sciences
Deposit date:
2016-12-14
Year:
2016
Author:
Κουτούζη Φωτεινή
Dissertation committee:
Τσακρής Αθανάσιος, Καθηγητής Μικροβιολογίας, Ιατρική Σχολή, ΕΚΠΑ
Δαΐκος Λ. Γεώργιος, Καθηγητής Παθολογίας-Λοιμώξεων, Ιατρική Σχολή, ΕΚΠΑ
Συριοπούλου Βασιλική, Ομότιμη Καθηγήτρια Παιδιατρικής, Ιατρική Σχολή,ΕΚΠΑ
Παπαγρηγορίου-Θεοδωρίδου Μαρία-Αλεξάνδρα, Ομότιμη Καθηγήτρια Παιδιατρικής, Ιατρική Σχολή,ΕΚΠΑ
Ρώμα Ελευθερία, Ομότιμη Καθηγήτρια Παιδιατρικής, Ιατρικής ΕΚΠΑ
Μίχος Αθανάσιος, Επίκουρος Καθηγητής Παιδιατρικής-Λοιμώξεων, Ιατρικής ΕΚΠΑ
Ζουμάκης Εμμανουήλ, Επίκουρος Καθηγητής, Ιατρικής ΕΚΠΑ
Original Title:
Γενετικά και φαινοτυπικά χαρακτηριστικά στελεχών β-αιμολυτικού στρεπτοκόκκου ομάδας Α απο παιδιά με διεισδυτικές και μη διεισδυτικές λοιμώξεις
Languages:
Greek
Summary:
Streptococcus pyogenes is an important human pathogen. The aims of the study were to investigate streptococcal infections in children (epidemiology, prevalence and diversity of emm-types, antibiotic susceptibility, macrolide resistant genes and pyrogenic exotoxins-SPE genes). This prospective study conducted 2007-2013, in children ≤14 years old. Identification of S.pyogenes was confirmed by standard techniques, emm typing by PCR and sequencing, and sensitivity to antibiotics by Kirby-Bauer and Etest. Macrolide resistant-genes and pyrogenic exotoxins genes detected by "multiplex" PCR. Analysis performed with SPSS, XLSTAT, x2 tests, Fisher and Pearson. A total of 1324 children (51.8% boys) were included in the study, median age 65 months. Pharyngitis occurred in 84.4%, invasive infections in 5.7% and otitis, pyoderma or vaginitis in 9.9%. Infections occurred in 67.8% of cases from November to May. Frequent were invasive infections in children ≤3 years old and pharyngeal 4-6 years old. Thirty-five different emm-types, including 15-subtypes, were identified. The most prevalent emm-types identified were 1(16.7%), 12(13.6%), 77(10.9%), 4(10.8%) and 28(10.4%). The 30-valent vaccine encompasses 97.3% of emm-types identified in the study. Classification of emm-types to emm-clusters indicated that 35 emm-types belonged to 13 emm-clusters. Antibiotic resistance found: macrolides 20.4%, clindamycin 13.8% (iMLSB 10.5%, cMLSB 3.3%), tetracycline 18.7% levofloxacin 5.4% and chloramphenicol 2.8%. Macrolide resistance genes were detected: erm(A) 50,4%, mef(A) 32.2% and erm(B) 16.3%. No correlation was observed in macrolide consumption and resistance. The speB genes or speA and speB, were often found in invasive isolates. Continuous surveillance of emm types is needed in order to evaluate the possible benefits of an M-protein-based S.pyogenes vaccine.
Main subject category:
Health Sciences
Keywords:
Streptococcus pyogenes, Streptococcal infections, Emm types, Macrolide resistance, Spe genes
Index:
No
Number of index pages:
0
Contains images:
Yes
Number of references:
360
Number of pages:
203

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