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Molecular and clinical characteristics of invasive group A streptococcal infection in Sweden

Darenberg, Jessica; Luca, Bogdan LU ; Jasir, Aftab LU ; Sandgren, Andreas; Pettersson, Helena; Scahlén, Claes; Norgren, Mari; Romanus, Victoria; Norrby-Teglund, Anna and Henriques Normark, Birgitta (2007) In Clinical Infectious Diseases 45(4). p.8-450
Abstract
Background. The incidence and severity of invasive group A streptococcal infection demonstrate great variability over time, which at least, in part, seems to be related to group A streptococcal type distribution among the human population.

Methods. An enhanced surveillance study of invasive group A streptococcal infection (746 isolates) was performed in Sweden from April 2002 through December 2004. Noninvasive isolates from either the throat or skin (773 isolates) were collected in parallel for comparison. Clinical and epidemiological data were obtained from 88% of patients with invasive disease and were related to isolate characteristics, including T type, emm sequence type, and the presence of 9 superantigen genes, as well as... (More)
Background. The incidence and severity of invasive group A streptococcal infection demonstrate great variability over time, which at least, in part, seems to be related to group A streptococcal type distribution among the human population.

Methods. An enhanced surveillance study of invasive group A streptococcal infection (746 isolates) was performed in Sweden from April 2002 through December 2004. Noninvasive isolates from either the throat or skin (773 isolates) were collected in parallel for comparison. Clinical and epidemiological data were obtained from 88% of patients with invasive disease and were related to isolate characteristics, including T type, emm sequence type, and the presence of 9 superantigen genes, as well as pulsed-field gel electrophoresis pattern comparisons of selected isolates.

Results. The annual incidence was 3.0 cases per 100,000 population. Among the patients with invasive disease, 11% developed streptococcal toxic shock syndrome, and 9.5% developed necrotizing fasciitis. The overall case-fatality rate was 14.5%, and 39% of the patients with streptococcal toxic shock syndrome died (P < .001). The T3/13/B3264 cluster accounted for 33% of invasive and 25% of noninvasive isolates. Among this most prevalent type cluster, emm types 89 and 81 dominated. Combined results from pulsed-field gel electrophoresis, emm typing, and superantigen gene profiling identified subgroups within specific emm types that are significantly more prone to cause invasive disease than were other isolates of the same type.

Conclusions. This study revealed a changing epidemiology of invasive group A streptococcal infection in Sweden, with emergence of new emm types that were previously not described. The results also suggest that some clones may be particularly prone to cause invasive disease. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Streptococcus pyogenes, PFGE, emm-types, surveillance, superantigens
in
Clinical Infectious Diseases
volume
45
issue
4
pages
8 - 450
publisher
The Infectious Diseases Society of America
external identifiers
  • Other:DOI: 10.1086/519936
  • Scopus:34547639552
ISSN
1537-6591
DOI
10.1086/519936
language
English
LU publication?
yes
id
bdae2527-bc0d-4251-9ed4-bf8e3048f839 (old id 584854)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed?term=Molecular%20and%20clinical%20characteristics%20of%20invasive%20group%20A%20streptococcal%20infection%20in%20Sweden
date added to LUP
2012-12-28 11:26:02
date last changed
2016-10-30 04:41:31
@misc{bdae2527-bc0d-4251-9ed4-bf8e3048f839,
  abstract     = {Background. The incidence and severity of invasive group A streptococcal infection demonstrate great variability over time, which at least, in part, seems to be related to group A streptococcal type distribution among the human population.<br/><br>
 Methods. An enhanced surveillance study of invasive group A streptococcal infection (746 isolates) was performed in Sweden from April 2002 through December 2004. Noninvasive isolates from either the throat or skin (773 isolates) were collected in parallel for comparison. Clinical and epidemiological data were obtained from 88% of patients with invasive disease and were related to isolate characteristics, including T type, emm sequence type, and the presence of 9 superantigen genes, as well as pulsed-field gel electrophoresis pattern comparisons of selected isolates. <br/><br>
 Results. The annual incidence was 3.0 cases per 100,000 population. Among the patients with invasive disease, 11% developed streptococcal toxic shock syndrome, and 9.5% developed necrotizing fasciitis. The overall case-fatality rate was 14.5%, and 39% of the patients with streptococcal toxic shock syndrome died (P &lt; .001). The T3/13/B3264 cluster accounted for 33% of invasive and 25% of noninvasive isolates. Among this most prevalent type cluster, emm types 89 and 81 dominated. Combined results from pulsed-field gel electrophoresis, emm typing, and superantigen gene profiling identified subgroups within specific emm types that are significantly more prone to cause invasive disease than were other isolates of the same type. <br/><br>
 Conclusions. This study revealed a changing epidemiology of invasive group A streptococcal infection in Sweden, with emergence of new emm types that were previously not described. The results also suggest that some clones may be particularly prone to cause invasive disease.},
  author       = {Darenberg, Jessica and Luca, Bogdan and Jasir, Aftab and Sandgren, Andreas and Pettersson, Helena and Scahlén, Claes and Norgren, Mari and Romanus, Victoria and Norrby-Teglund, Anna and Henriques Normark, Birgitta},
  issn         = {1537-6591},
  keyword      = {Streptococcus pyogenes,PFGE,emm-types,surveillance,superantigens},
  language     = {eng},
  number       = {4},
  pages        = {8--450},
  publisher    = {ARRAY(0x8472f20)},
  series       = {Clinical Infectious Diseases},
  title        = {Molecular and clinical characteristics of invasive group A streptococcal infection in Sweden},
  url          = {http://dx.doi.org/10.1086/519936},
  volume       = {45},
  year         = {2007},
}