Distribution of emm types among group A Streptococcus isolates from children in Korea

We analyzed 155 clinical group A Streptococcus (GAS) isolates from children at the Seoul National University Children's Hospital between 1991 and 2012 and the Seoul National University Bundang Hospital between 2006 and 2012. The erythromycin resistance rate was 10.3% (16/155), and all isolates during the recent 3 years were susceptible to erythromycin. Among isolates, emm1 (19.4%), emm12 (18.7%), and emm4 (18.1%) were the most prevalent emm types. According to clinical disease, emm1 was most common in invasive GAS infections (47.4%), and emm4, in scarlet fever (48.8%). From 2010 to 2012, an increase in invasive GAS infections and scarlet fever that correlated with an increase in emm1 and emm4 types was observed. The speC detection rate was higher in patients with scarlet fever than in those with other GAS infections (P = 0.017). Recently, invasive GAS infections and scarlet fever were associated with an increase in emm1 and emm4, respectively.