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Article in Japanese

Invasive group A streptococcal infection and emm typing in children

Keiko OKITA1), Yuta AIZAWA1), Kahoru FUKUOKA1), Yuho HORIKOSHI1)

Data are limited regarding the association between clinical pictures and emm genotypes coding M protein in children with invasive group A streptococcal (GAS) infection. This study retrospectively reviewed age, sex, underlying diseases, clinical diagnoses, emm genotype, length of hospital stay, antimicrobial susceptibility, and prognosis of patients with invasive GAS infection at Tokyo Metropolitan Children's Medical Center between April 2010 and March 2017. Among 16 invasive GAS cases, 13 strains were available for emm genotyping. They consisted of emm1.0 (n=5, 31%), emm89 (n=3, 19%), emm12 (n=3, 19%), emm28 (n=1, 6%), and emm3 (n=1, 6%). Clinical diagnoses included septic arthritis (n=5, 31%), abscess (n=4, 25%), skin and soft tissue infection (n=3, 19%), osteomyelitis (n=3, 19%), empyema (n=2, 13%), peritoneal dialysis-associated peritonitis (n=1, 6%), and catheter-related bloodstream infection (n=1, 6%). The association between clinical pictures and emm genotypes was not identified. The common emm genotypes were consistent with a previous Japanese survey of streptococcal toxic shock syndrome. A further study is warranted for an adequate evaluation of GAS vaccine in development that targets major M proteins.

1) Division of Infectious Diseases, Department of Pediatrics Tokyo Metropolitan Chil dren's Medical Center

Key words group A streptococcus, emm typing, M protein, invasive GAS infection, children
Received November 3, 2017
Accepted April 9, 2018

30 (2):115─120,2018