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Streptococcus pyogenes endometritis- a population-based study on the causative emm-types, case clustering and disease severity

Carblom, Anja ; Senneby, Erik LU ; Gunnarsson, Omar Sigurvin LU orcid ; Petersson, Ann-Cathrine LU and Rasmussen, Magnus LU orcid (2026) In European Journal of Clinical Microbiology and Infectious Diseases
Abstract
Purpose
Streptococcus pyogenes is a cause of endometritis, a severe infection in women of reproductive age. S. pyogenes is classified into emm-types based on variations of the emm-gene. We aimed to compare the distribution of emm-types in endometritis to that of controls with bacteraemia, and to assess associations between emm-types and disease severity or clustering of cases.

Methods
Vaginal or cervical cultures of S. pyogenes from Departments for gynaecology and obstetrics in Skåne, between 2012 and 2020, were identified. Clinical data on patients were retrieved from medical records. Inclusion required an event (childbirth, abortion, miscarriage, intrauterine device insertion or gynaecologic surgery) within 42 days prior... (More)
Purpose
Streptococcus pyogenes is a cause of endometritis, a severe infection in women of reproductive age. S. pyogenes is classified into emm-types based on variations of the emm-gene. We aimed to compare the distribution of emm-types in endometritis to that of controls with bacteraemia, and to assess associations between emm-types and disease severity or clustering of cases.

Methods
Vaginal or cervical cultures of S. pyogenes from Departments for gynaecology and obstetrics in Skåne, between 2012 and 2020, were identified. Clinical data on patients were retrieved from medical records. Inclusion required an event (childbirth, abortion, miscarriage, intrauterine device insertion or gynaecologic surgery) within 42 days prior to symptom onset. A cluster was defined as ≥ 2 patients with the same emm-type at the same hospital within 14 days. Emm-types of isolates from post-event infections were compared to those of isolates from blood.

Results
A total of 120 patients were identified, 107 had endometritis and 13 had post-event fever. Vaginal delivery was the most common preceding event (79%). Twenty-six patients (22%) fulfilled sepsis criteria, 15 patients required surgical intervention and six were admitted to the ICU. The distribution of emm-types differed significantly between groups (p < 0.001): emm89 was most prevalent in endometritis (21%), whereas emm1 predominated in bacteraemia (33% of 642 isolates). Five suspected clusters involving 12 patients were identified. No significant associations were found between emm-type and disease severity or clustering.

Conclusion
The emm-type distribution differed between endometritis and bacteraemia groups, suggesting variation in the propensity of specific emm-types to cause endometritis. (Less)
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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
European Journal of Clinical Microbiology and Infectious Diseases
publisher
Springer Science and Business Media B.V.
external identifiers
  • pmid:41922654
  • scopus:105034799968
ISSN
0934-9723
DOI
10.1007/s10096-026-05491-8
language
English
LU publication?
yes
id
376b2fbf-95db-43ea-bdde-d8bb756214f1
date added to LUP
2026-04-02 09:01:43
date last changed
2026-05-25 05:39:05
@article{376b2fbf-95db-43ea-bdde-d8bb756214f1,
  abstract     = {{Purpose<br/>Streptococcus pyogenes is a cause of endometritis, a severe infection in women of reproductive age. S. pyogenes is classified into emm-types based on variations of the emm-gene. We aimed to compare the distribution of emm-types in endometritis to that of controls with bacteraemia, and to assess associations between emm-types and disease severity or clustering of cases.<br/><br/>Methods<br/>Vaginal or cervical cultures of S. pyogenes from Departments for gynaecology and obstetrics in Skåne, between 2012 and 2020, were identified. Clinical data on patients were retrieved from medical records. Inclusion required an event (childbirth, abortion, miscarriage, intrauterine device insertion or gynaecologic surgery) within 42 days prior to symptom onset. A cluster was defined as ≥ 2 patients with the same emm-type at the same hospital within 14 days. Emm-types of isolates from post-event infections were compared to those of isolates from blood.<br/><br/>Results<br/>A total of 120 patients were identified, 107 had endometritis and 13 had post-event fever. Vaginal delivery was the most common preceding event (79%). Twenty-six patients (22%) fulfilled sepsis criteria, 15 patients required surgical intervention and six were admitted to the ICU. The distribution of emm-types differed significantly between groups (p &lt; 0.001): emm89 was most prevalent in endometritis (21%), whereas emm1 predominated in bacteraemia (33% of 642 isolates). Five suspected clusters involving 12 patients were identified. No significant associations were found between emm-type and disease severity or clustering.<br/><br/>Conclusion<br/>The emm-type distribution differed between endometritis and bacteraemia groups, suggesting variation in the propensity of specific emm-types to cause endometritis.}},
  author       = {{Carblom, Anja and Senneby, Erik and Gunnarsson, Omar Sigurvin and Petersson, Ann-Cathrine and Rasmussen, Magnus}},
  issn         = {{0934-9723}},
  language     = {{eng}},
  month        = {{04}},
  publisher    = {{Springer Science and Business Media B.V.}},
  series       = {{European Journal of Clinical Microbiology and Infectious Diseases}},
  title        = {{Streptococcus pyogenes endometritis- a population-based study on the causative emm-types, case clustering and disease severity}},
  url          = {{http://dx.doi.org/10.1007/s10096-026-05491-8}},
  doi          = {{10.1007/s10096-026-05491-8}},
  year         = {{2026}},
}