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Streptococcus dysgalactiae subsp. equisimilis from invasive and non-invasive infections in Spain: combining epidemiology, molecular characterization, and genetic diversity

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Abstract

The purpose of this study was to characterize the antibiotic resistance, virulence, and genetic diversity among invasive and non-invasive Streptococcus dysgalactiae subsp. equisimilis (SDSE) isolates. SDSE were isolated from clinical samples of outpatients and inpatients cares in La Rioja region (Spain) during 2012–2015. The analyses performed were susceptibility testing by disc diffusion, resistance and virulence genes by PCR, emm typing by PCR and sequencing, and other molecular typing by SmaI-PFGE and MLST. Forty-two SDSE isolates were recovered (64.3% non-invasive, 35.7% invasive) that were grouped in 31 PFGE patterns, 17 ST, and 14 emm types, being stC1400, stG6792, and stG62647 the most frequent, and stC74a and stC5345 exclusive in invasive SDSE. Twenty-one SDSE were resistant to at least one antibiotic. The erm(TR) and erm(B) genes were linked with resistance to macrolides; tet(M) and tet(T) to tetracycline; dfrF to trimethoprim; ant(6)-Ia and aph(3′)-IIIa to aminoglycosides; and the substitutions Asp80Ala in GyrA and Ser79Phe in ParC with resistance to levofloxacin. The sagA, slo, scpA, and ska virulence genes were amplified in 93% SDSE. Streptococcal superantigenic speGdys gene was identified in 80% of invasive and 63% of non-invasive SDSE and correlated with certain emm types (e.g., stG62647 or stG6792). SDSE invasive infections were most frequent in elderly patients, and half of our SDSE were resistant to at least one antibiotic tested. This work is the first detection of tet(T), dfrF, and new substitution in GyrA protein in SDSE. A high diversity of circulating genetic lineages was found among our SDSE.

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Acknowledgments

This study was supported by financial support of the own institution (Fundación Rioja Salud). Preliminary results from this study were presented at the 27th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID, Vienna, Austria 22-25 April 2017) and 28th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID, Madrid, Spain 21–24 April 2018).

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Author notes

  1. Nerea Ortega-Unanue

    Present address: Unidad de Genética, Hospital Universitario Donostia, San Sebastian, Spain

Authors and Affiliations

  1. Área de Microbiología Molecular, Centro de Investigación Biomédica de La Rioja (CIBIR), Piqueras Street, n° 98, 26006, Logroño, Spain

    Beatriz Rojo-Bezares, Laura Toca, Paula Toledano & Yolanda Sáenz

  2. Departamento de Diagnóstico Biomédico, Laboratorio de Microbiología, Hospital San Pedro, Logroño, Spain

    José Manuel Azcona-Gutiérrez

  3. Departamento de Diagnóstico Biomédico, Laboratorio de Análisis Clínicos, Hospital San Pedro, Logroño, Spain

    Nerea Ortega-Unanue

Authors
  1. Beatriz Rojo-Bezares
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Contributions

LT, PT, and NOU performed the experimental work. JMAG provided the strains and data collection. YS designed the study and provided the scientific background. BRB performed, analyzed, interpreted the experiments, and wrote the draft manuscript. LT, PT, NOU, JMAG, YS, and BRB revised the manuscript and gave their final opinion on its intellectual content.

Corresponding author

Correspondence to Beatriz Rojo-Bezares.

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The authors declare that they have no competing interests.

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Ethical approval for this study was obtained from the Ethical Committee of Clinical Research of La Rioja (CEImLAR P.I. 455).

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Rojo-Bezares, B., Toca, L., Azcona-Gutiérrez, J.M. et al. Streptococcus dysgalactiae subsp. equisimilis from invasive and non-invasive infections in Spain: combining epidemiology, molecular characterization, and genetic diversity. Eur J Clin Microbiol Infect Dis 40, 1013–1021 (2021). https://doi.org/10.1007/s10096-020-04119-9

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  • DOI: https://doi.org/10.1007/s10096-020-04119-9

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