{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T01:49:22Z","timestamp":1762998562366},"reference-count":24,"publisher":"American Society for Microbiology","issue":"6","license":[{"start":{"date-parts":[[2006,6,1]],"date-time":"2006-06-01T00:00:00Z","timestamp":1149120000000},"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":[[2006,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            The genetic diversity of group A streptococci (GAS) throughout much of the world has not been adequately explored. To assess genetic variation among GAS in western Nepal, 120 noninvasive GAS, collected from eight different villages, were genetically characterized using\n            <jats:italic>emm<\/jats:italic>\n            typing,\n            <jats:italic>sof<\/jats:italic>\n            sequencing, and multilocus sequence typing (MLST). A high level of genetic diversity was observed among these isolates, with 51 genotypes based upon 51 multilocus sequence types (STs), 45\n            <jats:italic>emm<\/jats:italic>\n            sequence types, and 28\n            <jats:italic>sof<\/jats:italic>\n            sequence types. On the basis of shared ST\n            <jats:italic>-emm<\/jats:italic>\n            and\n            <jats:italic>sof<\/jats:italic>\n            -\n            <jats:italic>emm<\/jats:italic>\n            associations, 40 of the 51 genotypes were identical or highly related to genotypes characterized from locations outside of Nepal, even though most of the\n            <jats:italic>emm<\/jats:italic>\n            sequence and clonal types are rare among GAS within the United States. When analyzing all known STs highly related to Nepal STs, only one example of similar STs shared between a\n            <jats:italic>sof<\/jats:italic>\n            PCR-positive strain and a\n            <jats:italic>sof<\/jats:italic>\n            PCR-negative strain was observed. Since previous data indicate free exchange of MLST loci between\n            <jats:italic>sof<\/jats:italic>\n            -positive and\n            <jats:italic>sof<\/jats:italic>\n            -negative strains, there is possibly selection against the expansion of subclones resulting from horizontal transfers of\n            <jats:italic>sof<\/jats:italic>\n            or\n            <jats:italic>emm<\/jats:italic>\n            genes between\n            <jats:italic>sof<\/jats:italic>\n            -positive and\n            <jats:italic>sof<\/jats:italic>\n            -negative strains. All 45\n            <jats:italic>emm<\/jats:italic>\n            types encountered in Nepal have also been documented from other countries. These data, together with data encompassing the past decade of\n            <jats:italic>emm<\/jats:italic>\n            type surveillance, support the possibility that most existing GAS\n            <jats:italic>emm<\/jats:italic>\n            types have been discovered. Similarly, since most (40\/51) strain types were highly related to strains found elsewhere, it is likely that a major fraction of the existing GAS clonal complexes have been discovered.\n          <\/jats:p>","DOI":"10.1128\/jcm.02456-05","type":"journal-article","created":{"date-parts":[[2006,6,7]],"date-time":"2006-06-07T10:58:07Z","timestamp":1149677887000},"page":"2160-2166","update-policy":"http:\/\/dx.doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":42,"title":["Genetically Diverse Group A Streptococci from Children in Far-Western Nepal Share High Genetic Relatedness with Isolates from Other Countries"],"prefix":"10.1128","volume":"44","author":[{"given":"Varja","family":"Sakota","sequence":"first","affiliation":[{"name":"Division of Bacterial and Mycotic Diseases, Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alicia M.","family":"Fry","sequence":"additional","affiliation":[{"name":"Division of Bacterial and Mycotic Diseases, Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas M.","family":"Lietman","sequence":"additional","affiliation":[{"name":"Proctor Foundation and the Department of Ophthalmology, University of California at San Francisco, San Francisco, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard R.","family":"Facklam","sequence":"additional","affiliation":[{"name":"Division of Bacterial and Mycotic Diseases, Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhongya","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Bacterial and Mycotic Diseases, Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernard","family":"Beall","sequence":"additional","affiliation":[{"name":"Division of Bacterial and Mycotic Diseases, Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1099\/00221287-146-5-1195"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1086\/315842"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/173.4.896"},{"key":"e_1_3_2_5_2","unstructured":"Centers for Disease Control and Prevention. 2006. CDC emm sequence database. [Online.] http:\/\/www.cdc.gov\/ncidod\/biotech\/strep\/emmtypes.htm\n."},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2958.1999.01328.x"},{"key":"e_1_3_2_7_2","first-page":"833","volume":"12","year":"2005","unstructured":"Dale, J. B., T. Penfound, E. Y. Chiang, V. Long, S. T. Shulman, and B. Beall. 2005. Multivalent group A streptococcal vaccine elicits bactericidal antibodies against variant M subtypes. Clin. Diagn. Lab. Immunol.12:833-836.","journal-title":"Clin. Diagn. Lab. Immunol."},{"key":"e_1_3_2_8_2","first-page":"3987","volume":"46","year":"2001","unstructured":"Dicuonzo, G., E. Fiscarelli, G. Gherardi, G. Lorino, F. Battistoni, S. Landi, M. De Cesaris, T. Petitti, and B. Beall. 2001. Erythromycin-resistant pharyngeal isolates of Streptococcus pyogenes recovered in Italy. Antimicrob. Agents Chemother.46:3987-3990.","journal-title":"Antimicrob. 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