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Echocardiographic Parameters, Clinical Profile and Presence of Streptococcus pyogenes Virulent Genes in Pharyngitis and Rheumatic Fever. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2022. [DOI: 10.22207/jpam.16.2.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Streptococcus pyogenes is a gram positive pathogen causing pharyngitis, mild infections to chronic complications (Rheumatic Heart Disease, RHD). In this study, echocardiographic and clinical profile in pharyngitis, rheumatic fever patients were compared with virulent genes emm, spe A, spe B and sof. Nearly 107 subjects were classified into Group I – Pharyngitis (n=30), Group II – Rheumatic Fever (n=30) and Group III – healthy controls (n=47). The isolated S.pyogenes from Group I and Group II patient’s throat swab were subjected to 16S rRNA gene sequence. Multiplex PCR was done for identification of virulent genes. Electrocardiogram and Echocardiography was done for all the groups. For statistical analysis ANOVA and t-test were used. Comparison between groups were done by Tukey’s Multiple Comparison test. Among 107 isolates, 16.7% emm gene were detected in Group I and 23.3% in Group II, 56.67 % of spe B in Group I and 73.33 % in Group II, 36.67% of sof gene in Group I and 40% in Group II. Mitral Regurgitation was most commonly encountered in rheumatic fever. Hemoglobin (<0.001) and RDW (<0.001) was significantly lower in Rheumatic Fever whereas Platelet count (<0.001) and Neutrophil (<0.001) was significantly higher when compared with control subjects by Tukey’s Multiple Comparison test. When we compared the genetic relationship with the Echocardiographic findings, presence of one, two or three genes showed moderate to severe regurgitation in Rheumatic Fever subjects.
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Ray D, Saha S, Sinha S, Pal NK, Bhattacharya B. Molecular characterization and evaluation of the emerging antibiotic-resistant Streptococcus pyogenes from eastern India. BMC Infect Dis 2016; 16:753. [PMID: 27955635 PMCID: PMC5153692 DOI: 10.1186/s12879-016-2079-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Accepted: 11/29/2016] [Indexed: 11/18/2022] Open
Abstract
Background Group A Streptococcus strains causing wide variety of diseases, recently became noticeable in eastern India, are not amenable to standard treatment protocol thus enhancing the possibility of disease morbidity by becoming antibiotic resistance. Methods The association of Lancefield group A Streptococcal variation with degree of vir architectural diversity was evaluated using emm typing and restriction fragment length polymorphism analyses. The antibiotic sensitivity patterns were examined by modified Kirby-Bauer method of disk diffusion. Percentage calculations, 95% confidence interval and one-way ANOVA were used to assess differences in proportions. Results Our observations revealed 20 different emm types and 13 different HaeIII vir typing patterns. A 1.2 kb fragment was found in all HaeIII typing pattern. Fragments of 1.2 kb and 550 bp were conserved in majority of the isolates. HinfI digestion was found proficient in differentiating the strains of same vir typing patterns. Strong predominance of speC (85%) and speF (80%) genes have been observed encoding exotoxins production. 4 isolates were found to be erythromycin resistant and were of genotype emm49. High degree of tetracycline resistance was shown by 53.57% isolates which belonged to 12 different emm genotypes. Conclusions These findings suggested that in addition to emm typing, sequential application of HaeIII and HinfI restriction enzymes in vir typing analysis is an effective tool for group A streptococcal molecular characterization associated with antibiotic resistance. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-2079-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Dipanwita Ray
- Biochemistry Research Wing, Department of Biochemistry, Dr. B C Roy Post Graduate Institute of Basic Medical Education and Research (IPGME&R), 244B, A J C Bose Road, Kolkata, 700020, India.
| | - Somnath Saha
- Nil Ratan Sarkar Medical College and Hospital, Kolkata, India
| | - Sukanta Sinha
- The West Bengal University of Health Sciences, Kolkata, India
| | | | - Basudev Bhattacharya
- Biochemistry Research Wing, Department of Biochemistry, Dr. B C Roy Post Graduate Institute of Basic Medical Education and Research (IPGME&R), 244B, A J C Bose Road, Kolkata, 700020, India. .,Health and Family Welfare Department, Directorate of Medical Education, Government of Tripura, 799001, Agartala, Tripura, India.
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Devi U, Borah PK, Malik V, Parida P, Mahanta J. M types & toxin gene profile of group A streptococci isolated from children in Dibrugarh district of Assam, India. Indian J Med Res 2016; 143:659-62. [PMID: 27488011 PMCID: PMC4989841 DOI: 10.4103/0971-5916.187116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Affiliation(s)
- Utpala Devi
- Regional Medical Research Centre, NE Region (ICMR), Post Box-105, Dibrugarh 786 001, Assam, India
| | - Prasanta Kumar Borah
- Regional Medical Research Centre, NE Region (ICMR), Post Box-105, Dibrugarh 786 001, Assam, India
| | - Vinita Malik
- Regional Medical Research Centre, NE Region (ICMR), Post Box-105, Dibrugarh 786 001, Assam, India
| | - Pratap Parida
- Regional Medical Research Centre, NE Region (ICMR), Post Box-105, Dibrugarh 786 001, Assam, India
| | - Jagadish Mahanta
- Regional Medical Research Centre, NE Region (ICMR), Post Box-105, Dibrugarh 786 001, Assam, India
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Wu PC, Lo WT, Chen SJ, Wang CC. Molecular characterization of Group A streptococcal isolates causing scarlet fever and pharyngitis among young children: A retrospective study from a northern Taiwan medical center. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2014; 47:304-10. [DOI: 10.1016/j.jmii.2013.02.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Revised: 01/03/2013] [Accepted: 01/18/2013] [Indexed: 11/28/2022]
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Streptococcal superantigens: categorization and clinical associations. Trends Mol Med 2013; 20:48-62. [PMID: 24210845 DOI: 10.1016/j.molmed.2013.10.004] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Revised: 10/01/2013] [Accepted: 10/08/2013] [Indexed: 01/01/2023]
Abstract
Superantigens are key virulence factors in the immunopathogenesis of invasive disease caused by group A streptococcus. These protein exotoxins have also been associated with severe group C and group G streptococcal infections. A number of novel streptococcal superantigens have recently been described with some resulting confusion in their classification. In addition to clarifying the nomenclature of streptococcal superantigens and proposing guidelines for their categorization, this review summarizes the evidence supporting their involvement in various clinical diseases including acute rheumatic fever.
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Balaji K, Thenmozhi R, Prajna L, Dhananjeyan G, Pandian SK. Comparative analysis of emm types, superantigen gene profiles and antibiotic resistance genes among Streptococcus pyogenes isolates from ocular infections, pharyngitis and asymptomatic children in south India. INFECTION GENETICS AND EVOLUTION 2013; 19:105-12. [PMID: 23851012 DOI: 10.1016/j.meegid.2013.06.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 06/11/2013] [Accepted: 06/15/2013] [Indexed: 10/26/2022]
Abstract
Group A Streptococcus (Streptococcus pyogenes) is responsible for a wide array of infections and incidence is high in developing countries like India. Although distribution of emm types of S. pyogenes in India has been described, its association with the virulence genes and ocular isolates is less concentrated. In the present study emm type surveillance as well as its association with toxin gene profile was analyzed. Ocular infected cases such as lacrimal abscess, corneal ulcers, mucocoele showed the presence of 20 S. pyogenes isolates. For noninvasive isolates, we screened 370 pharyngitis cases and 400 asymptomatic school children and recovered 33 pharyngitis and 14 carrier isolates respectively. 14 Emm type distributions were observed in ocular isolates, 11 emm types each in pharyngitis and asymptomatic carrier isolates. The two dominant emm types, emm49 and emm63 were accounted for 33% of the total S. pyogenes isolates. Among ocular isolates, slo, smeZ, speB and speG were found in >50% of isolates, in pharyngitis smeZ (48%), speB (45%) and speG (42%) genes were found to be prevalent. Alarmingly, carrier isolates showed more prevalence to virulence genes than the ocular and pharyngitis isolates with speF (79%), speB, speG (64%), slo and sil (64%). Among the three groups, pharyngitis isolates harbored more prtF1 (33%) and prtF2 (94%) than the asymptomatic carriers (28% and 71%) and the ocular isolates (45% and 40%). 450bp Size band in prtF1 and 350bp size band in prtF2 showed dominance. Among the three groups tested, the distribution of ermB and mefA was high in pharyngitis isolates (30%) where 10 isolates showed the presence of both genes. None of the isolates showed the presence of ermA and tetO genes. Dendrogram generated based on the virulence and antibiotic resistance gene profiles revealed that except one cluster, all other clusters showed some correlation with ocular, pharyngitis and asymptomatic carrier isolates, irrespective of their emm types.
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Affiliation(s)
- Kannan Balaji
- Department of Biotechnology, Alagappa University, Karaikudi, Tamil Nadu, India
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Commons R, Rogers S, Gooding T, Danchin M, Carapetis J, Robins-Browne R, Curtis N. Superantigen genes in group A streptococcal isolates and their relationship with emm types. J Med Microbiol 2008; 57:1238-1246. [DOI: 10.1099/jmm.0.2008/001156-0] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Robert Commons
- Murdoch Children’s Research Institute, Royal Children’s Hospital Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Australia
| | - Susan Rogers
- Murdoch Children’s Research Institute, Royal Children’s Hospital Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Australia
| | - Travis Gooding
- Murdoch Children’s Research Institute, Royal Children’s Hospital Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Australia
| | - Margie Danchin
- Infectious Diseases Unit, Department of General Medicine, Royal Children’s Hospital Melbourne, Australia
- Murdoch Children’s Research Institute, Royal Children’s Hospital Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Australia
| | - Jonathan Carapetis
- Infectious Diseases Unit, Department of General Medicine, Royal Children’s Hospital Melbourne, Australia
- Murdoch Children’s Research Institute, Royal Children’s Hospital Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Australia
| | - Roy Robins-Browne
- Department of Microbiology & Immunology, The University of Melbourne, Australia
- Murdoch Children’s Research Institute, Royal Children’s Hospital Melbourne, Australia
| | - Nigel Curtis
- Infectious Diseases Unit, Department of General Medicine, Royal Children’s Hospital Melbourne, Australia
- Murdoch Children’s Research Institute, Royal Children’s Hospital Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Australia
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Sagar V, Kumar R, Ganguly NK, Chakraborti A. Comparative analysis of emm type pattern of Group A Streptococcus throat and skin isolates from India and their association with closely related SIC, a streptococcal virulence factor. BMC Microbiol 2008; 8:150. [PMID: 18796133 PMCID: PMC2556678 DOI: 10.1186/1471-2180-8-150] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2008] [Accepted: 09/16/2008] [Indexed: 12/02/2022] Open
Abstract
Background Group A streptococcus (GAS) causes a wide variety of life threatening diseases in humans and the incidence of such infections is high in developing countries like India. Although distribution of emm types of GAS in India has been described, there is a lack of data describing either the comparative distribution of emm types in throat versus skin isolates, or the distribution of certain virulence factors amongst these isolates. Therefore in the present study we have monitored the emm type pattern of Group A streptococcus throat and skin isolates from India. Additionally, the association of these isolates with closely related sic (crs), a multifunctional compliment binding virulence factor, was also explored. Results Of the 94 (46 throat and 48 skin) isolates analyzed, 37 emm types were identified. The most frequently observed emm types were emm49 (8.5%) and emm112 (7.5%) followed by 6.5% each of emm1-2, emm75, emm77, and emm81. Out of 37 emm types, 27 have been previously reported and rest were isolated for the first time in the Indian Community. The predominant emm types of throat (emm49 and emm75) samples were different from those of skin (emm44, emm81 and emm112) samples. After screening all the 94 isolates, the crs gene was found in six emm1-2 (crs1-2) isolates, which was confirmed by DNA sequencing and expression analysis. Despite the polymorphic nature of crs, no intravariation was observed within crs1-2. However, insertions and deletions of highly variable sizes were noticed in comparison to CRS isolated from other emm types (emm1.0, emm57). CRS1-2 showed maximum homology with CRS57, but the genomic location of crs1-2 was found to be the same as that of sic1.0. Further, among crs positive isolates, speA was only present in skin samples thus suggesting possible role of speA in tissue tropism. Conclusion Despite the diversity in emm type pattern of throat and skin isolates, no significant association between emm type and source of isolation was observed. The finding that the crs gene is highly conserved even in two different variants of emm1-2 GAS (speA +ve and -ve) suggests a single allele of crs may be prevalent in the highly diverse throat and skin isolates of GAS in India.
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Affiliation(s)
- Vivek Sagar
- Department of Experimental Medicine & Biotechnology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
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Creti R, Gherardi G, Imperi M, von Hunolstein C, Baldassarri L, Pataracchia M, Alfarone G, Cardona F, Dicuonzo G, Orefici G. Association of group A streptococcal emm types with virulence traits and macrolide-resistance genes is independent of the source of isolation. J Med Microbiol 2005; 54:913-917. [PMID: 16157543 DOI: 10.1099/jmm.0.46035-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Streptococcus pyogenes (group A streptococci; GAS) recovered from paediatric pharyngitis (101 isolates) and asymptomatic children (79 isolates) in the same geographical area and period, as well as isolates collected during an enhanced national surveillance programme for GAS invasive diseases (79 isolates), were screened for the incidence of the streptococcal pyrogenic exotoxin (spe) genes speA and speC, as well as the macrolide-resistance genes erm(B), erm(A) subclass erm(TR) and mef(A), and typed by emm sequencing. The speA gene was detected with comparable incidence among throat isolates (13.9 % of asymptomatic children and 16.8 % of pharyngitis isolates) and in 25 % of invasive cases; in contrast, speC incidence was, surprisingly, higher in paediatric populations (55.4 % in pharyngitis isolates and 65.8 % in asymptomatic children) than in invasive isolates (30 %; P < 0.0001). Macrolide resistance was detected in 26.6, 38.0 and 37.6 % of strains belonging to invasive, asymptomatic and pharyngitis populations, respectively. The different incidences of exotoxin and antibiotic-resistance genes among populations did not appear to have an intrinsic clinical significance, but may reflect the propensity of these traits to be associated with certain emm types independent of the source from which the strains were isolated. Further investigations with larger emm-type populations are warranted to confirm this.
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Affiliation(s)
- Roberta Creti
- Dipartimento di Malattie Infettive, Parassitarie ed Immunomediate, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy 2Dipartimento di Medicina di Laboratorio e Microbiologia, Università Campus Biomedico, Via Emilio Longoni 83, 00155 Rome, Italy 3Dipartimento di Scienze Neurologiche, Psichiatriche e Riabilitative dell'Età Evolutiva, Università 'La Sapienza', Via dei Sabelli 108, 00185 Rome, Italy
| | - Giovanni Gherardi
- Dipartimento di Malattie Infettive, Parassitarie ed Immunomediate, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy 2Dipartimento di Medicina di Laboratorio e Microbiologia, Università Campus Biomedico, Via Emilio Longoni 83, 00155 Rome, Italy 3Dipartimento di Scienze Neurologiche, Psichiatriche e Riabilitative dell'Età Evolutiva, Università 'La Sapienza', Via dei Sabelli 108, 00185 Rome, Italy
| | - Monica Imperi
- Dipartimento di Malattie Infettive, Parassitarie ed Immunomediate, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy 2Dipartimento di Medicina di Laboratorio e Microbiologia, Università Campus Biomedico, Via Emilio Longoni 83, 00155 Rome, Italy 3Dipartimento di Scienze Neurologiche, Psichiatriche e Riabilitative dell'Età Evolutiva, Università 'La Sapienza', Via dei Sabelli 108, 00185 Rome, Italy
| | - Christina von Hunolstein
- Dipartimento di Malattie Infettive, Parassitarie ed Immunomediate, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy 2Dipartimento di Medicina di Laboratorio e Microbiologia, Università Campus Biomedico, Via Emilio Longoni 83, 00155 Rome, Italy 3Dipartimento di Scienze Neurologiche, Psichiatriche e Riabilitative dell'Età Evolutiva, Università 'La Sapienza', Via dei Sabelli 108, 00185 Rome, Italy
| | - Lucilla Baldassarri
- Dipartimento di Malattie Infettive, Parassitarie ed Immunomediate, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy 2Dipartimento di Medicina di Laboratorio e Microbiologia, Università Campus Biomedico, Via Emilio Longoni 83, 00155 Rome, Italy 3Dipartimento di Scienze Neurologiche, Psichiatriche e Riabilitative dell'Età Evolutiva, Università 'La Sapienza', Via dei Sabelli 108, 00185 Rome, Italy
| | - Marco Pataracchia
- Dipartimento di Malattie Infettive, Parassitarie ed Immunomediate, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy 2Dipartimento di Medicina di Laboratorio e Microbiologia, Università Campus Biomedico, Via Emilio Longoni 83, 00155 Rome, Italy 3Dipartimento di Scienze Neurologiche, Psichiatriche e Riabilitative dell'Età Evolutiva, Università 'La Sapienza', Via dei Sabelli 108, 00185 Rome, Italy
| | - Giovanna Alfarone
- Dipartimento di Malattie Infettive, Parassitarie ed Immunomediate, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy 2Dipartimento di Medicina di Laboratorio e Microbiologia, Università Campus Biomedico, Via Emilio Longoni 83, 00155 Rome, Italy 3Dipartimento di Scienze Neurologiche, Psichiatriche e Riabilitative dell'Età Evolutiva, Università 'La Sapienza', Via dei Sabelli 108, 00185 Rome, Italy
| | - Francesco Cardona
- Dipartimento di Malattie Infettive, Parassitarie ed Immunomediate, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy 2Dipartimento di Medicina di Laboratorio e Microbiologia, Università Campus Biomedico, Via Emilio Longoni 83, 00155 Rome, Italy 3Dipartimento di Scienze Neurologiche, Psichiatriche e Riabilitative dell'Età Evolutiva, Università 'La Sapienza', Via dei Sabelli 108, 00185 Rome, Italy
| | - Giordano Dicuonzo
- Dipartimento di Malattie Infettive, Parassitarie ed Immunomediate, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy 2Dipartimento di Medicina di Laboratorio e Microbiologia, Università Campus Biomedico, Via Emilio Longoni 83, 00155 Rome, Italy 3Dipartimento di Scienze Neurologiche, Psichiatriche e Riabilitative dell'Età Evolutiva, Università 'La Sapienza', Via dei Sabelli 108, 00185 Rome, Italy
| | - Graziella Orefici
- Dipartimento di Malattie Infettive, Parassitarie ed Immunomediate, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy 2Dipartimento di Medicina di Laboratorio e Microbiologia, Università Campus Biomedico, Via Emilio Longoni 83, 00155 Rome, Italy 3Dipartimento di Scienze Neurologiche, Psichiatriche e Riabilitative dell'Età Evolutiva, Università 'La Sapienza', Via dei Sabelli 108, 00185 Rome, Italy
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Sagar V, Bakshi DK, Nandi S, Ganguly NK, Kumar R, Chakraborti A. Molecular heterogeneity among north Indian isolates of Group A Streptococcus. Lett Appl Microbiol 2004; 39:84-8. [PMID: 15189292 DOI: 10.1111/j.1472-765x.2004.01545.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To monitor molecular heterogeneity among the clinical isolates of group A Streptococcus (GAS) from north India by Vir and emm typing. METHODS AND RESULTS GAS isolates, 31 from pharyngitis and nine from rheumatic fever (RF)/rheumatic heart disease (RHD) patients were differentiated into 16 Vir types (VT). These isolates were further discriminated into 23 emm types. Most of emm types were Vir type specific, except few (7.5%), which revealed different Vir types within same emm type. The most prevalent emm type found was emm 49 (15%) followed by 7.5% of emm 69, emm 71 and emm 75 which were different from emm type distribution reported from south India. CONCLUSIONS Analysis of data revealed 40% heterogeneity by Vir typing and 57.5% by emm typing among GAS isolates which is significant in view of small number of isolates studied. SIGNIFICANCE OF IMPACT OF THE STUDY: The molecular study for the first time demonstrates different emm types prevalent and circulating in northern region of India and such data may help in selection of types for vaccine development.
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Affiliation(s)
- V Sagar
- Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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