Annals of Clinical Microbiology, The official Journal of the Korean Society of Clinical Microbiology


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Epidemiology and Erythromycin Resistance of Streptococcus pyogenes in the Last 20 Years

Review article

Annals of Clinical Microbiology (Ann Clin Microbiol) 2011 December, Volume 14, Issue 4, pages 119-125.

Epidemiology and Erythromycin Resistance of Streptococcus pyogenes in the Last 20 Years

Sunjoo Kim

Department of Laboratory Medicine, Gyeongsang National University School of Medicine, Gyeongsang Institute of Health Sciences, Jinju, Korea


Serological methods for the epidemiological study of Streptococcus pyogenes, such as T-, or M-typing, were replaced by emm typing in the 2000s. The frequency of emm types may differ according to geographical area and study period. Erythromycin resistance rates and the prevalence of erythromycin-resistant phenotypes in several countries are surveyed, and common emm genotypes associated with erythromycin resistance are described for each country. There is no correlation between erythromycin resistance and macrolide use in Korea. S. pyogenes is thought to cause severe illness, such as streptococcal toxic shock syndrome (STSS) and necrotizing fasciitis. The mortality rate of STSS is about 50%, and there have been several hundred victims of STSS in Japan in the last 2 decades. The resistance rate to macrolides peaked at 50% in 2002, and currently, <10% of strains exhibit macrolide resistance in Korea. However, the erythromycin resistance rate recently exceeded 90% in China. Considering increases of travel between neighboring countries, a vigilant survey to monitor these highly virulent and antibiotic-resistant strains is necessary. (Korean J Clin Microbiol 2011;14:119-125)


Streptococcus pyogenes, Group A streptococci, emm, Epidemiology, Erythromycin resistance