Molecular and Clinical Characterization of Invasive <i>Streptococcus pyogenes</i> Isolates: Insights from Two Northern-Italy Centers

<i>Streptococcus pyogenes</i> (Group A Streptococcus, GAS) is a Gram-positive pathogen responsible for both superficial and invasive infections (iGAS), with increasing global incidence in recent years. This study aims to characterize the molecular and clinical features of iGAS cases in B...

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Main Authors: Carmelo Bonomo, Eva Mannino, Dafne Bongiorno, Caterina Vocale, Armando Amicucci, Dalida Bivona, Davide Guariglia, Emanuele Nicitra, Grete Francesca Privitera, Giuseppe Sangiorgio, Stefania Stefani, Simone Ambretti
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Language:English
Published: MDPI AG 2025-02-01
Series:Pathogens
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Online Access:https://www.mdpi.com/2076-0817/14/2/152
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author Carmelo Bonomo
Eva Mannino
Dafne Bongiorno
Caterina Vocale
Armando Amicucci
Dalida Bivona
Davide Guariglia
Emanuele Nicitra
Grete Francesca Privitera
Giuseppe Sangiorgio
Stefania Stefani
Simone Ambretti
author_facet Carmelo Bonomo
Eva Mannino
Dafne Bongiorno
Caterina Vocale
Armando Amicucci
Dalida Bivona
Davide Guariglia
Emanuele Nicitra
Grete Francesca Privitera
Giuseppe Sangiorgio
Stefania Stefani
Simone Ambretti
author_sort Carmelo Bonomo
collection DOAJ
description <i>Streptococcus pyogenes</i> (Group A Streptococcus, GAS) is a Gram-positive pathogen responsible for both superficial and invasive infections (iGAS), with increasing global incidence in recent years. This study aims to characterize the molecular and clinical features of iGAS cases in Bologna and Imola (Italy) between 2022 and 2024. Thirty-five invasive isolates were analyzed through whole-genome sequencing (WGS) to investigate the distribution of emm types, antimicrobial resistance (AMR) genes, and virulence factors. Clinical and epidemiological data were retrospectively collected and analyzed. The majority of cases (80%) were recorded in 2023, predominantly among patients aged over 65 (60%). Bloodstream infections were present in 97.1% of cases, and comorbidities such as diabetes and immunosuppression were common. Empirical antibiotic therapy often involved penicillin/β-lactam inhibitors, while oxazolidinones were the most frequently used in targeted regimens. The in-hospital mortality rate was 20%. Genomic analysis identified <i>emm</i>1, <i>emm</i>12, and <i>emm</i>89 as the most prevalent types, associated with specific virulence profiles and resistance determinants. This study highlights the critical role of <i>emm</i> typing and genomic characterization in understanding the pathogenicity of GAS. These findings contribute to the identification of risk factors for severe outcomes and underscore the need for targeted prevention and treatment strategies in vulnerable populations.
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spelling doaj-art-f2f63f45ae7b46b684f1d2ecb05b44222025-08-20T02:44:47ZengMDPI AGPathogens2076-08172025-02-0114215210.3390/pathogens14020152Molecular and Clinical Characterization of Invasive <i>Streptococcus pyogenes</i> Isolates: Insights from Two Northern-Italy CentersCarmelo Bonomo0Eva Mannino1Dafne Bongiorno2Caterina Vocale3Armando Amicucci4Dalida Bivona5Davide Guariglia6Emanuele Nicitra7Grete Francesca Privitera8Giuseppe Sangiorgio9Stefania Stefani10Simone Ambretti11Department of Biomedical and Biotechnological Sciences (BIOMETEC), University of Catania, 95124 Catania, ItalyDepartment of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, ItalyDepartment of Biomedical and Biotechnological Sciences (BIOMETEC), University of Catania, 95124 Catania, ItalyMicrobiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyDepartment of Medical and Surgical Sciences, Section of Microbiology, University of Bologna, 40136 Bologna, ItalyDepartment of Biomedical and Biotechnological Sciences (BIOMETEC), University of Catania, 95124 Catania, ItalyDepartment of Medical and Surgical Sciences, Section of Microbiology, University of Bologna, 40136 Bologna, ItalyDepartment of Biomedical and Biotechnological Sciences (BIOMETEC), University of Catania, 95124 Catania, ItalyDepartment of Clinical and Experimental Medicine, Department of Mathematical and Computational Science, University of Catania, 95124 Catania, ItalyDepartment of Biomedical and Biotechnological Sciences (BIOMETEC), University of Catania, 95124 Catania, ItalyDepartment of Biomedical and Biotechnological Sciences (BIOMETEC), University of Catania, 95124 Catania, ItalyMicrobiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy<i>Streptococcus pyogenes</i> (Group A Streptococcus, GAS) is a Gram-positive pathogen responsible for both superficial and invasive infections (iGAS), with increasing global incidence in recent years. This study aims to characterize the molecular and clinical features of iGAS cases in Bologna and Imola (Italy) between 2022 and 2024. Thirty-five invasive isolates were analyzed through whole-genome sequencing (WGS) to investigate the distribution of emm types, antimicrobial resistance (AMR) genes, and virulence factors. Clinical and epidemiological data were retrospectively collected and analyzed. The majority of cases (80%) were recorded in 2023, predominantly among patients aged over 65 (60%). Bloodstream infections were present in 97.1% of cases, and comorbidities such as diabetes and immunosuppression were common. Empirical antibiotic therapy often involved penicillin/β-lactam inhibitors, while oxazolidinones were the most frequently used in targeted regimens. The in-hospital mortality rate was 20%. Genomic analysis identified <i>emm</i>1, <i>emm</i>12, and <i>emm</i>89 as the most prevalent types, associated with specific virulence profiles and resistance determinants. This study highlights the critical role of <i>emm</i> typing and genomic characterization in understanding the pathogenicity of GAS. These findings contribute to the identification of risk factors for severe outcomes and underscore the need for targeted prevention and treatment strategies in vulnerable populations.https://www.mdpi.com/2076-0817/14/2/152<i>Streptococcus pyogenes</i>invasive group A Streptococcus (iGAS)whole genome sequencing (WGS)
spellingShingle Carmelo Bonomo
Eva Mannino
Dafne Bongiorno
Caterina Vocale
Armando Amicucci
Dalida Bivona
Davide Guariglia
Emanuele Nicitra
Grete Francesca Privitera
Giuseppe Sangiorgio
Stefania Stefani
Simone Ambretti
Molecular and Clinical Characterization of Invasive <i>Streptococcus pyogenes</i> Isolates: Insights from Two Northern-Italy Centers
Pathogens
<i>Streptococcus pyogenes</i>
invasive group A Streptococcus (iGAS)
whole genome sequencing (WGS)
title Molecular and Clinical Characterization of Invasive <i>Streptococcus pyogenes</i> Isolates: Insights from Two Northern-Italy Centers
title_full Molecular and Clinical Characterization of Invasive <i>Streptococcus pyogenes</i> Isolates: Insights from Two Northern-Italy Centers
title_fullStr Molecular and Clinical Characterization of Invasive <i>Streptococcus pyogenes</i> Isolates: Insights from Two Northern-Italy Centers
title_full_unstemmed Molecular and Clinical Characterization of Invasive <i>Streptococcus pyogenes</i> Isolates: Insights from Two Northern-Italy Centers
title_short Molecular and Clinical Characterization of Invasive <i>Streptococcus pyogenes</i> Isolates: Insights from Two Northern-Italy Centers
title_sort molecular and clinical characterization of invasive i streptococcus pyogenes i isolates insights from two northern italy centers
topic <i>Streptococcus pyogenes</i>
invasive group A Streptococcus (iGAS)
whole genome sequencing (WGS)
url https://www.mdpi.com/2076-0817/14/2/152
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