{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T13:10:34Z","timestamp":1791897034424,"version":"4.3.4"},"reference-count":36,"publisher":"American Society for Microbiology","issue":"2","license":[{"start":{"date-parts":[[2014,2,1]],"date-time":"2014-02-01T00:00:00Z","timestamp":1391212800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2014,2]]},"abstract":"ABSTRACT<\/jats:title>\n \n Our multicenter nationwide surveillance data indicated that erythromycin (ERY) resistance among group A\n Streptococcus<\/jats:named-content>\n (GAS) isolates in Taiwan declined from 53.1% in 1998 and 2000 to 14.6% in 2002 and 2004 and 10.7% in 2006 to 2010 (\n P<\/jats:italic>\n < 0.01). The present study aimed to assess the epidemiology of GAS in Taiwan and identify factors associated with ERY resistance. All 127 ERY-resistant (ERY\n r<\/jats:sup>\n ) isolates and 128 randomly selected ERY-susceptible (ERY\n s<\/jats:sup>\n ) isolates recovered from 1998 to 2010 were\n emm<\/jats:italic>\n typed. ERY\n r<\/jats:sup>\n isolates were also characterized by ERY resistance phenotype and mechanisms and pulsed-field gel electrophoresis (PFGE). Multilocus sequence typing was performed on selected ERY\n r<\/jats:sup>\n isolates. The predominant\n emm<\/jats:italic>\n types in ERY\n r<\/jats:sup>\n isolates were\n emm<\/jats:italic>\n 22 (\n n<\/jats:italic>\n = 33, 26.0%),\n emm<\/jats:italic>\n 12 (\n n<\/jats:italic>\n = 24, 18.9%),\n emm<\/jats:italic>\n 4 (\n n<\/jats:italic>\n = 21, 16.5%), and\n emm<\/jats:italic>\n 106 (\n n<\/jats:italic>\n = 15, 11.8%). In ERY\n s<\/jats:sup>\n isolates,\n emm<\/jats:italic>\n 12 (\n n<\/jats:italic>\n = 27, 21.9%),\n emm<\/jats:italic>\n 1 (\n n<\/jats:italic>\n = 18, 14.1%),\n emm<\/jats:italic>\n 106 (\n n<\/jats:italic>\n = 16, 12.5%), and\n emm<\/jats:italic>\n 11 (\n n<\/jats:italic>\n = 9, 7.1%) predominated. The most common ERY resistance phenotype was the M phenotype (resistant to macrolides) (70.9%), with all but one isolate carrying\n mef<\/jats:italic>\n (A), followed by the constitutive macrolide-lincosamide-streptogramin B resistance (cMLS\n B<\/jats:sub>\n ) phenotype (26.8%), with isolates carrying\n erm<\/jats:italic>\n (B) or\n erm<\/jats:italic>\n (TR). ERY\n r<\/jats:sup>\n isolates of the\n emm<\/jats:italic>\n 12-sequence type 36 (ST36) lineage with the cMLS\n B<\/jats:sub>\n phenotype were mostly present before 2004, while those of the\n emm<\/jats:italic>\n 22-ST46 lineage with the M phenotype predominated in later years. Recovery from respiratory (throat swab) specimens was an independent factor associated with ERY resistance.\n emm<\/jats:italic>\n 1 and\n emm<\/jats:italic>\n 11 GAS isolates were significantly associated with ERY\n s<\/jats:sup>\n , while\n emm<\/jats:italic>\n 22 was detected only in ERY\n r<\/jats:sup>\n GAS. In addition,\n emm<\/jats:italic>\n 106 isolates were prevalent among the abscess\/pus isolates, whereas\n emm<\/jats:italic>\n 12 isolates were strongly associated with a respiratory (throat) origin. In addition to identifying factors associated with ERY resistance in GAS, our study provides helpful information on the changing GAS epidemiology in Taiwan.\n <\/jats:p>","DOI":"10.1128\/jcm.02383-13","type":"journal-article","created":{"date-parts":[[2013,12,5]],"date-time":"2013-12-05T02:02:43Z","timestamp":1386208963000},"page":"508-516","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":26,"title":["Epidemiology and Molecular Characterization of Macrolide-Resistant Streptococcus pyogenes in Taiwan"],"prefix":"10.1128","volume":"52","author":[{"given":"Chia-Ying","family":"Huang","sequence":"first","affiliation":[{"name":"National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jui-Fen","family":"Lai","sequence":"additional","affiliation":[{"name":"National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I-Wen","family":"Huang","sequence":"additional","affiliation":[{"name":"National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei-Chen","family":"Chen","sequence":"additional","affiliation":[{"name":"National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui-Ying","family":"Wang","sequence":"additional","affiliation":[{"name":"National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yih-Ru","family":"Shiau","sequence":"additional","affiliation":[{"name":"National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya-Wen","family":"Cheng","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Yun","family":"Hsieh","sequence":"additional","affiliation":[{"name":"National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shan-Chwen","family":"Chang","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsai-Ling Yang","family":"Lauderdale","sequence":"additional","affiliation":[{"name":"National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(03)00576-0"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(05)70267-X"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.34.4.953-958.1996"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(09)70178-1"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01133-12"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis847"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.48.9.3559-3562.2004"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1086\/427946"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1086\/383309"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmm.2012.09.001"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid1809.120049"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.47.9.2844-2849.2003"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/42.2.257"},{"key":"e_1_3_2_15_2","first-page":"239","article-title":"Surveillance of antibiotic resistance in Taiwan, 1998","volume":"32","author":"Ho M","year":"1999","unstructured":"HoMMcDonaldLCLauderdaleTLYehLLChenPCShiauYR. 1999. 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