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Clinical and epidemiological aspects of invasive Streptococcus pyogenes infections in Denmark during 2003 and 2004

Luca, Bogdan LU ; Ekelund, Kim; van der Linden, Mark; Staum-Kaltoft, Margit; Hammerum, Anette and Jasir, Aftab LU (2008) In Journal of Clinical Microbiology 46(1). p.79-86
Abstract
Active surveillance of invasive group A streptococcal (GAS) infections was conducted in Denmark during

2003 and 2004 as a part of the Strep-EURO initiative. The main objective was to improve understanding of the

epidemiology of invasive GAS disease in Denmark. During the 2 years, 278 cases were reported, corresponding

to a mean annual incidence of 2.6 cases per 100,000 inhabitants. The vast majority of isolates, 253 (91%), were

from blood, with the remaining 25 (9%) being from cerebrospinal fluid, joints, or other normally sterile sites.

The mean case fatality rate (CFR) was 20%, with the rate being higher in patients more than 70 years of age

(36.5%). For streptococcal toxic shock... (More)
Active surveillance of invasive group A streptococcal (GAS) infections was conducted in Denmark during

2003 and 2004 as a part of the Strep-EURO initiative. The main objective was to improve understanding of the

epidemiology of invasive GAS disease in Denmark. During the 2 years, 278 cases were reported, corresponding

to a mean annual incidence of 2.6 cases per 100,000 inhabitants. The vast majority of isolates, 253 (91%), were

from blood, with the remaining 25 (9%) being from cerebrospinal fluid, joints, or other normally sterile sites.

The mean case fatality rate (CFR) was 20%, with the rate being higher in patients more than 70 years of age

(36.5%). For streptococcal toxic shock syndrome (STSS) and necrotizing fasciitis the CFRs were 53% and 25%,

respectively. Out of 16 T types recorded, three predominated: T28 (23%), T1 (22%), and the cluster T3/13/B3264

(14%). Among 29 different emm types, emm28 and emm1 accounted for 51% of strains, followed by emm3 (11%),

emm89 (7%), and emm12 (5.5%). Low resistance rates were detected for macrolide-lincosamide-streptogramin

B (MLSB) antibiotics (3%) and tetracycline (8%); two isolates exhibited coresistance to tetracycline and

macrolides. Of nine pyrogenic exotoxin (superantigen) genes examined, speA and speC were identified in 58%

and 40% of the strains, respectively; either of the genes was present in all strains causing STSS. Most strains

harbored speG (99%). ssa was present in 14% of the isolates only. In Denmark, as in comparable countries, GAS

invasive disease shows a sustained, high endemicity, with involvement of both established and emerging

streptococcal emm and T types. (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
streptococcal toxic shock syndrome, Streptococcus pyogenes, invasive group A streptococcal disease, antibiotic resistance, necrotising fasciitis
in
Journal of Clinical Microbiology
volume
46
issue
1
pages
79 - 86
publisher
American Society for Microbiology
external identifiers
  • wos:000252392200009
  • scopus:38149141425
ISSN
1098-660X
DOI
10.1128/JCM.01626-07
project
Strep-EURO
language
English
LU publication?
yes
id
69ed5c32-86c8-428e-973c-14c5fc8dfe59 (old id 951571)
date added to LUP
2008-09-12 09:08:24
date last changed
2017-08-27 04:31:20
@article{69ed5c32-86c8-428e-973c-14c5fc8dfe59,
  abstract     = {Active surveillance of invasive group A streptococcal (GAS) infections was conducted in Denmark during<br/><br>
2003 and 2004 as a part of the Strep-EURO initiative. The main objective was to improve understanding of the<br/><br>
epidemiology of invasive GAS disease in Denmark. During the 2 years, 278 cases were reported, corresponding<br/><br>
to a mean annual incidence of 2.6 cases per 100,000 inhabitants. The vast majority of isolates, 253 (91%), were<br/><br>
from blood, with the remaining 25 (9%) being from cerebrospinal fluid, joints, or other normally sterile sites.<br/><br>
The mean case fatality rate (CFR) was 20%, with the rate being higher in patients more than 70 years of age<br/><br>
(36.5%). For streptococcal toxic shock syndrome (STSS) and necrotizing fasciitis the CFRs were 53% and 25%,<br/><br>
respectively. Out of 16 T types recorded, three predominated: T28 (23%), T1 (22%), and the cluster T3/13/B3264<br/><br>
(14%). Among 29 different emm types, emm28 and emm1 accounted for 51% of strains, followed by emm3 (11%),<br/><br>
emm89 (7%), and emm12 (5.5%). Low resistance rates were detected for macrolide-lincosamide-streptogramin<br/><br>
B (MLSB) antibiotics (3%) and tetracycline (8%); two isolates exhibited coresistance to tetracycline and<br/><br>
macrolides. Of nine pyrogenic exotoxin (superantigen) genes examined, speA and speC were identified in 58%<br/><br>
and 40% of the strains, respectively; either of the genes was present in all strains causing STSS. Most strains<br/><br>
harbored speG (99%). ssa was present in 14% of the isolates only. In Denmark, as in comparable countries, GAS<br/><br>
invasive disease shows a sustained, high endemicity, with involvement of both established and emerging<br/><br>
streptococcal emm and T types.},
  author       = {Luca, Bogdan and Ekelund, Kim and van der Linden, Mark and Staum-Kaltoft, Margit and Hammerum, Anette and Jasir, Aftab},
  issn         = {1098-660X},
  keyword      = {streptococcal toxic shock syndrome,Streptococcus pyogenes,invasive group A streptococcal disease,antibiotic resistance,necrotising fasciitis},
  language     = {eng},
  number       = {1},
  pages        = {79--86},
  publisher    = {American Society for Microbiology},
  series       = {Journal of Clinical Microbiology},
  title        = {Clinical and epidemiological aspects of invasive Streptococcus pyogenes infections in Denmark during 2003 and 2004},
  url          = {http://dx.doi.org/10.1128/JCM.01626-07},
  volume       = {46},
  year         = {2008},
}