Serotype distribution across <i>Streptococcus suis</i> strains isolated from pig tonsils.

<p>@ Serotyping was repeated three times; additional analysis of 7 representative strains by MLST and 16S rDNA sequencing confirmed that these strains are S. suis.</p><p>*Includes serotype 5, 8, 9,10, 11, 12, 13, 15, 19, 20, 22, 23, 25, 26, 27, 28, 29, 30, 31, 33.</p><p>**Strains reacting with antisera against two or three different serotypes.</p><p>#23 strains were auto-agglutinating, 16 strains could not be assigned to any serotype after agglutination with polyvalent antisera, and 6 strains reacted negatively with all poly-valent antisera.</p

Provinces of Vietnam.

<p>Provinces (coloured) from which sampled pig originated are located in the south of Vietnam and surrounding Ho Chi Minh City.</p

Pulse field gel electrophoresis (PFGE) of <i>Streptococcus suis</i> serotype 2 strains isolated from tonsils of healthy pigs.

<p>Six <i>S. suis</i> serotype 2 strains isolated from patients with meningitis in southern Vietnam whose PFGE patterns represent the dominant PFGE patterns across <i>S. suis</i> serotype 2 strains isolated from humans (labeled A–F), were included for comparison purpose. A dendrogram was generated by Dice analysis (band tolerance, 1.3%) and cluster analysis with unweighted pair group method with arithmetic mean, using Bionumerics software (Applied Maths, Belgium). Bars indicate 95% confidence intervals. Columns: Cls: PFGE cluster; Pro: province of pig's origin or patients' residence; Date: date of tonsil collection or patients' admission; SH: slaughterhouse ID; WS: Whole sale seller ID; ST: sequence type, Res: tetracycline and erythromycin resistance gene detected by PCR and sequencing, ef: <i>epf</i> or <i>epf*</i> gene detected by PCR. CC: Cu Chi- HCMC; LA: Long An; HM: Hoc Mon – HCMC; HCM: Ho Chi Minh City; BD: Binh Duong; BTr: Ben Tre; DN: Dong Nai; BTh: Binh Thuan. O: amplicons of <i>tet</i>(O) gene detected. M: amplicons of <i>tet</i>(M) gene detected. B: amplicons of <i>erm</i>(B) gene detected. L: amplicons of <i>tet</i>(L) gene detected *: amplicons of mosaic tetracyclin resistance encoding gene <i>tet</i>(O/W/32/O) detected in these strains. #: no amplicons of <i>erm</i>(A), <i>erm</i>(B) or <i>mef</i>(A) were detected in these erythormycine resistant strains. 0: no amplicons of <i>epf</i> or <i>epf*</i> gene detected. 1: amplicons of <i>epf</i> gene detected. 2: amplicons of <i>epf</i>* gene detected.</p

Sampling of tonsils and associated culture results.

<p>*Pigs sampled in slaughterhouse I originated from (number of samples): Ben Tre province (25), Binh Duong province (31), Dong Nai province (75); slaughterhouse II: Binh Duong province (55), Binh Thuan province (83), Ho Chi Minh City (Hoc Mon) (12), Long An province (30), Tien Giang province (34); slaughterhouse III: Binh Duong province (50), Ho Chi Minh City (Cu Chi) (84), Long An province (37).</p

Clinical characteristics and laboratory values of children on admission, and outcome

†<p>Date of vaccination unless otherwise stated.</p>‡<p>HBV: Hepatitis B virus. Both received Euvax B™; MMR: Measles, Mumps, Rubella. All received Priorix™; varicella: Varilrix^R.</p>§<p>swelling at injection site beyond the expected after routine vaccination.</p>∥<p>Inotropes used were dopamine, dobutamine, noradrenaline.</p>**<p>MRSA: methicillin-resistant <i>Staphylococcus aureus</i>. NA denotes not available, a plus sign positive or present, and a minus sign negative or absent.</p>*<p>Normal ranges are as follows: hemoglobin concentration, 105–135 g/L; leukocyte count, 6 to 17.5·10⁹/L; platelet count, 150 to 400·10⁹/L; alanine aminotransferase (ALT) level, below 37 U/L; aspartate aminotransferase (AST) level, below 40 U/L; creatine phosphokinase (CK) below 200 U/L; serum creatinine concentration, 18–80 µmol/L;</p

Key virulence and resistance genes in isolates HCM3A, HT2001 751, and MW2 as detected by microarray.

*<p>Confirmed with PCR and/or sequencing</p>**<p>Microarray data cannot conclusively prove the location of a gene. Assignation to a MGE is based on known location of that gene in other sequenced strains.</p><p><i>hla</i>, α-haemolysin; <i>hlgACB</i>, γ-haemolysin; <i>hld</i>, δ-haemolysin; <i>clf</i>, clumping factors; ST, sequence type using MLST; <i>cap8</i>, capsule type 8; <i>sasG</i>, accumulation associated protein SA2285; <i>coa</i> M0206v, coagulase with four types described; <i>sasA</i>, haemagglutinin like gene which can contain an insert; <i>cna</i>, collagen binding protein; <i>sdr</i>, serine aspartate repeat proteins; <i>fnbpA</i>, fibronectin binding protein with three types described; <i>lytN</i>, cell wall hydrolase; <i>agr</i>, accessory gene regulator with 4 classes described; <i>trap</i>, target of RNAIII activating protein with 2 types described; <i>sarT</i>, staphylococcal accessory regulator T; MGE, mobile genetic element; SCC, staphylococcal cassette chromosome; <i>mec</i>, methicillin resistance; <i>ccr</i>, cassette chromosome recombinase with 3 types described; <i>far1</i>, putative fusidic acid resistance; <i>PV-luk</i>, Panton Valentine leukocidin; <i>seg</i>, enterotoxin G; <i>sak</i>, staphylokinase; <i>sea</i>, enterotoxin A; <i>sek</i>, enterotoxin K; <i>seb</i>, enterotoxin B; <i>sec</i>, enterotoxin C; <i>bla</i>, β-lactamase; <i>cad</i>, cadmium resistance; <i>ars</i>, arsenic resistance; <i>bacteriocin</i>, putative bacteriocin gene SAR0694-5; - denotes gene not detected; #, phage unrelated to PV-<i>luk</i> phage in MW2.</p

Rapidly progressive soft tissue infection after vaccination.

<p>Severe tissue necrosis around vaccination site in Child 4, two days following vaccination with MMR. MRSA was cultured from wound fluid.</p