Emergence of uncommon emm types of Streptococcus pyogenes among adult patients in southern Taiwan
ABSTRACT Streptococcus pyogenes isolated from adult patients during a 12-year period in southern Taiwan were analyzed to estimate the distribution of emm types and their correlation with disease manifestations and patient age.
Three hundred thirty-four invasive and noninvasive isolates collected from patients older than 20 years between 1997 and 2008 at National Cheng Kung University Hospital were included for emm typing. A correlation between emm type, disease manifestations, and patient ages was analyzed.
The nine most prevalent types were emm11, emm12, emm4, emm1, Sp9458/VT8, emm81, emm106, emm13, and emm75. Formerly rare emm types, including emm11, emm81, and emm102, emerged dramatically after 2004 in southern Taiwan. Type emm11 was significantly associated with both superficial infections and cellulitis. In addition, types emm13, emm81, and emm106 were more prevalent in patients older than 50 years and significantly associated with specific invasive disease manifestation.
These results suggest new emm types (emm11, emm81, and emm102) of S pyogenes were introduced into the adult population in southern Taiwan after 2004. The rarely reported emm types, including emm13, emm81, and emm106, caused invasive diseases more often in adult patients.
- SourceAvailable from: Heinz P. Bohlen
Conference Paper: Development of a 10-MW, L-band, multiple-beam klystron for TESLA[Show abstract] [Hide abstract]
ABSTRACT: A high-efficiency, Multiple-Beam Klystron (MBK), designated the VKL-8301, is being manufactured for the DESY Tera Electron volt Superconducting Linear Accelerator (TESLA) in Hamburg, Germany. There are a number of excellent reasons for using an MBK for this application. The primary reasons are reduced size and lower operating voltage with respect to the conventional, single beam counterparts. Once this decision has been made, the class of MBK must now be selected. MBKs can be divided into two categories: Fundamental Mode (FM) and Higher-order Mode (HM) devices, distinguished by the interaction mode of the cavity resonators. Each class has inherent advantages and disadvantages dependent upon end-user requirements. For the 10 MW, 1.3 GHz TESLA application the HM-MBK is the clear choice. The primary factor influencing this choice was operational life, since the accelerator will require approximately 600 MBKs. The advantage of the HM approach is low cathode loading. Our cathode loading design goal of 2 A/cm<sup>2</sup> or less has been achieved. For this application the HM-MBK cathode loading is a factor of four lower than competing FM-MBK designs and a factor of three lower than the SLAC 5045 design. The VKL-8301 will use six off-axis electron beams interacting with a combination of TM<sub>010</sub> and hybrid TM<sub>020</sub> cavities. These six beams are equally spaced on a diameter of approximately 25 centimeters. Because of the large beam-to-beam separation, individual high-area convergence guns can be utilized versus the single multi-emission-site gun used in FM-MBK's. This solution requires a sophisticated focusing system that is relatively difficult to realize, compounded by our use of confined-flow focusing. Newly developed, state-of-the-art three- dimensional electromagnetics codes have been used to design the novel electron-beam-focusing system and microwave cavity geometry. Modeling and simulation results will be presented, hardware will be shown, and a description of the FM- versus HM-MBK selection process will be discussed.Particle Accelerator Conference, 2003. PAC 2003. Proceedings of the; 06/2003
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ABSTRACT: BACKGROUND: In Taiwan, clinical and microbiological data on acute otitis media (AOM) with spontaneous otorrhea in children are limited. MATERIALS AND METHODS: We retrospectively collected data on children with AOM and spontaneous otorrhea between January 2011 and June 2012. Otorrhea samples were collected using sterile swabs and sent for cultures. Pathogens found were Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pyogenes, and Staphylococcus aureus. Pneumococcal isolates collected from October 2011 to June 2012 were serotyped. RESULTS: A total of 92 patients were enrolled in the study for demographic and microbiological analysis. Their median age was 2.5 years. After excluding those with lobar pneumonia, 84 patients were included for analysis of clinical manifestation. The mean febrile duration was 6 days. Leukocytosis and C-reactive protein (CRP) level >50 mg/L were noted in 29 (34.5%) patients and 38 (45.2%) patients, respectively. Patients with pneumococcal infection were older (p = 0.007) and had more severe symptoms [fever (p = 0.001), otalgia (p = 0.055), respiratory symptoms (p = 0.002-0.03), and higher CRP level (p = 0.015)] than children with other bacterial infection. Otorrhea cultures were obtained from 69 (75%) patients, of whom 52 had definitive AOM pathogens. The most common causative pathogen was S. pneumoniae (61.5%), followed by S. aureus (36.5%). Serotype 19A accounted for two-thirds of pneumococcal isolates and had a high rate of nonsusceptibility to penicillin (66.7%) and ceftriaxone (83.3%). CONCLUSION: S. pneumoniae was found to be the most important source of AOM with spontaneous otorrhea in children and caused more severe symptoms. Serotype 19A, which was usually nonsusceptible to antimicrobial agents, was the most prevalent serotype in these patients.Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi 06/2013; DOI:10.1016/j.jmii.2013.04.001
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ABSTRACT: The aim of this study is to evaluate antibiotic susceptibilities, emm gene types, toxin gene profiles and clonal relatedness of group A streptococci (GAS) isolates obtained from patients and carriers. A total of 79 clinical isolates from patients and 60 isolates from carriers were included in the study. Emm typing, toxin gene detection for speA, speB, speC, speG and smeZ genes and pulsed-field gel electrophoresis (PFGE) was performed. Twenty-one distinct emm types were detected; the most common types were emm12, emm89, emm1, emm77, emm4 and emm3. The detection rates of both emm types and the toxin genes didn't differ significantly between patients and carriers. The presence of speA and smeZ was significantly higher in emm1 and speG was significantly lower in emm4 when compared to the other emm types. The rate of clustering obtained with PFGE wasn't significantly different in patients and carriers. As a result, twelve of the 21 emm types detected in this study were covered by the 26-valent vaccine, constituting 77.7% of the emm typeable isolates; however the emm4 type which is one of the most common types in the present study is not among this coverage.Bosnian journal of basic medical sciences / Udruzenje basicnih mediciniskih znanosti = Association of Basic Medical Sciences 08/2013; 13(3):163-9.