Outbreak of scarlet fever caused by an erythromycin-resistant Streptococcus pyogenes emm22 genotype strain in a day-care center

We report an outbreak of scarlet fever and pharyngeal colonization with Str eptococcus pyogenes in a day-care center in Mexico City. The outbreak strai n was resistant to erythromycin but susceptible to clindamycin. T-type 11,1 2 serotype was found in eight isolates, from two patients and six carriers, which had the emm22 gene. The recognition of streptococci resistant to mac rolides causing outbreaks has implications for infection control and for im proving antibiotic prescribing patterns in the day-care setting.