Invasive group A streptococcal infections in adults, France (2006-2010).

September 21, 2018 at 8:13 am

Clin Microbiol Infect. 2012 Jul;18(7):702-10.

Plainvert C1, Doloy A, Loubinoux J, Lepoutre A, Collobert G, Touak G, Trieu-Cuot P, Bouvet A, Poyart C; CNR-Strep network.

Abstract

Severe invasive group A streptococcal diseases have re-emerged during the past 10-20 years. In order to provide a better insight into the current epidemiological situation in France, we analysed the questionnaires regarding all invasive strains received at the National Reference Center for Streptococci (CNR-Strep) between 2006 and 2010 from patients aged ≥ 18 and characterized them by emm typing, spe gene detection and antibiotic resistance. Among the 1542 invasive GAS strains studied, 78% (n=1206) were from blood cultures, and a streptococcal toxic shock syndrome (STSS) was described in 22% (n=340) of cases, mainly associated with necrotizing fasciitis (NF) and pleuro-pulmonary infections (p<0.001). The in-hospital fatality rate was 15%. A total of 83 different emm types were recovered but the three predominant emm types, representing almost 60% of the isolates, were emm1 (24%), emm28 (17%) and emm89 (15%). The preponderance of each emm type varied according to the year, with a significant constant increase of emm28 strains, whereas emm1 strains, representing approximately 32% of GAS invasive isolates in 2007 and 2008, dropped to <15% in 2010 (p<0.001). The distribution of phage-associated superantigen genes (speA, speC and ssa) was linked to certain emm types. Between 2006 and 2010, the percentage that was macrolide-resistant decreased from 11% to 5%, confirming the trend observed in 2007. Fortunately, emm1 strains associated with the most life-threatening clinical manifestations remain susceptible to all anti-streptococcal antibiotics.

PDF

https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(14)64571-7/pdf

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Entry filed under: Antimicrobianos, Bacterias, Bacteriemias, Epidemiología, FIEBRE y RASH, Infecciones emergentes, Infecciones en piel y tej blandos, Metodos diagnosticos, REPORTS, Sepsis, Update.

The Association between Invasive Group A Streptococcal Diseases and Viral Respiratory Tract Infections. Invasive Group A streptococcal disease in Ireland, 2004 to 2010.


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