Population Genomic Molecular Epidemiological Study of Macrolide-Resistant Streptococcus pyogenes in Iceland, 1995 to 2016: Identification of a Large Clonal Population with a <i>pbp2x</i> Mutation Conferring Reduced <i>In Vitro</i> β-Lactam Susceptibility
Sara B. Southon, Stephen B. Beres, Priyanka Kachroo, Matthew Ojeda Saavedra, Helga Erlendsdóttir, Gunnsteinn Haraldsson, Prasanti Yerramilli, Layne Pruitt, Luchang Zhu, James M. Musser, Karl G. Kristinsson
Abstract
Resistance to macrolide antibiotics is a global concern in the treatment of Streptococcus pyogenes (group A Streptococcus [GAS]) infections. In Iceland, since the detection of the first macrolide-resistant isolate in 1998, three epidemic waves of macrolide-resistant GAS infections have occurred, with peaks in 1999, 2004, and 2008. We conducted whole-genome sequencing of all 1,575 available GAS macrolide-resistant clinical isolates of all infection types collected at the national reference laboratory in Reykjavik, Iceland, from 1998 to 2016.