emm typing of invasive T28 group A streptococci, 1995–2004, Finland

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Abstract
A total of 985 group A streptococcus (GAS) bacteraemia isolates collected in Finland during 1995–2004 were T-serotyped, and of these, 336 isolates of serotype T28 were subjected to furtheremmtyping. The total number of isolates referred per year showed an increase within the study period, from 43 in 1995 to 130 in 2004. The annual incidence of invasive GAS (iGAS) bacteraemia showed a general increase during the study period, from 1.1 to 2.5 per 100 000 population. Serotype T28 remained among the most common serotypes, in addition to serotypes TB3264 and T1. The serotype T28 isolates were found to be distributed across six distinctemmtypes:emm28,emm77,emm53 (including subtypes 53.2 and 53.4),emm87,emm2 andemm4. The serotype distribution and theemmtype distribution of serotype T28 fluctuated over time. Within the study period, the proportion of T28/emm28 isolates became the most prominent. During periods of lowemm28 incidence,emmtypes 77 and 53 seemed to show a resurgence.emmtyping revealed T28 isolates to be a genetically heterogeneous group harbouring a variety of distinct M proteins. This study confirms that T serotyping alone is not a sufficient method for epidemiological surveillance of iGAS.

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