Abstract: Streptococcus pyogenes  is regarded as susceptible to β-lactam antibiotics. The guidelines of the Clinical and Laboratory Standards Institute (CLSI) are widely recognized and have long-recommended penicillin for treatment of S. pyogenes  infections. There is no CLSI guideline for the treatment of S. pyogenes  infections that have intermediate susceptibility or resistance to penicillin. However, there have been several reports of S. pyogenes  isolates that are nonsusceptible or even resistant to β-lactam antibiotics, mostly from Chinese journals. The purpose of this commentary is to show data from the literature which suggests the presence of S. pyogenes  isolates that are not susceptible to β-lactam antibiotics and whether these strains are really nonsusceptible to β-lactam antibiotics and the presence of mutation in the pbp2x  gene requires further research and confirmation.
Keywords: Streptococcus pyogenes , GAS, β-lactam, antibiotic resistance, China