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Forty-one clinical isolates of group A streptococcus (GAS) were recovered in Poland from patients with severe invasive infections and were analyzed by phenotypic and genotypic techniques. All isolates were characterized by determining their susceptibilities to antimicrobial agents and by determining their types by pulsed-field gel electrophoresis, multilocus sequence typing,emm typing, and the detection of five streptococcal pyrogenic exotoxin genes (speA ,speB ,speC ,speF ,ssa ). The isolates studied were fully susceptible to penicillin G, levofloxacin, quinupristin-dalfopristin, and linezolid. Resistance to tetracycline, chloramphenicol, and erythromycin was detected in 46.3, 12.1, and 9.8% of the isolates, respectively. A total of 23 differentemm sequence types were identified, of whichemm1 andemm12 (19.5% each) were the most common, followed byemm81 ,emm44/61 , andemm85 . All theemm1 isolates had thespeA2 allele. Twenty-three unrelated sequence types (STs) were identified, with the most frequent STs, ST28 and ST36, corresponding toemm1 andemm12 , respectively. Six newly found STs (STs 375, 376, 377, 378, 379, and 385) corresponded toemm types 74, 102, 77, 76, 84 and 63, respectively. Theemm1 type and the presence ofspeA2 gene were associated with the severity of GAS infections. This work presents the first molecular study on Polish invasive GAS isolates.

Group A Streptococci from Invasive-Disease Episodes in Poland Are Remarkably Divergent at the Molecular Level