Adult Invasive and Noninvasive Infections Due to Streptococcus dysgalactiae subsp. equisimilis in France from 2006 to 2010

Loubinoux, Julien; Plainvert, Céline; Collobert, Gislène; Touak, Gérald; Bouvet, Anne; Poyart, Claire

doi:10.1128/jcm.01262-13

Cited by 54 publications

(41 citation statements)

References 33 publications

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“…Very few studies have been conducted on nGCGS, and to our knowledge, the finding has not previously been reported [17,27]. It is unclear, though, if this represents a true decrease in nGCGS morbidity.…”

Section: Discussioncontrasting

confidence: 63%

Beta-haemolytic group A, C and G streptococcal infections in Western Norway: a 15-year retrospective survey

Oppegaard

Mylvaganam

Kittang

2015

Clinical Microbiology and Infection

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Pyogenic streptococci cause significant morbidity and mortality, and the incidence of invasive group C and G streptococcal disease appears to be increasing. In this retrospective study we describe the epidemiological characteristics of invasive group A, C and G, along with non-invasive group C and G streptococcal infections in Western Norway from 1999 to 2013. A total of 512 invasive streptococcal infections were identified, of these 297 (58%) were group A (GAS), 24 (5%) group C (GCS) and 188 (37%) group G streptococci (GGS). In the non-invasive group, 4935 GCS and GGS-infections were identified. GCS and GGS were treated as one group (GCGS) for statistical purposes. All microbial categories displayed increasing incidence with age, seasonal variation and a male predominance. The incidence of invasive GCGS infections increased significantly from 1.4/100,000 inhabitants in 1999 to 6.3/100,000 in 2013 (p <0.001). Conversely, the annual rates of invasive GAS infection exhibited marked fluctuations, ranging from 2.7/100,000 (2000) to 8.3/100,000 (1999), but no significant temporal trends were observed. The incidence of non-invasive GCGS infections decreased significantly during the study period (p <0.001). The most frequently encountered emm-types among the 209 iGAS-isolates analysed were emm1 (24%), emm3 (14%) and emm28 (14%); whereas stG643 (19%), stG485 (15%) and stG6 (13%) were most prevalent among the 122 iGCGS-isolates available for typing. The increasing burden of invasive β-haemolytic streptococcal disease in our community calls for sustained attentiveness to the clinical and molecular aspects of GAS, GCS and GGS infections.

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Section: Discussioncontrasting

confidence: 63%

Beta-haemolytic group A, C and G streptococcal infections in Western Norway: a 15-year retrospective survey

Oppegaard

Mylvaganam

Kittang

2015

Clinical Microbiology and Infection

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“…The overall resistance rate to erythromycin in our study was similar to that reported in south India (12.2 %) for group C and G streptococci from humans (Prabu & Menon, 2013). However, a higher level of macrolide resistance (26.4 %) was detected for SDSE in France from 2006 to 2010 (Loubinoux et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Group C Streptococcus dysgalactiae subsp. equisimilis in south-east Brazil: genetic diversity, resistance profile and the first report of human and equine isolates belonging to the same multilocus sequence typing lineage

Silva

Genteluci

Mattos

et al. 2015

Journal of Medical Microbiology

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Group C Streptococcus dysgalactiae subsp. equisimilis in south-east Brazil: genetic diversity, resistance profile and the first report of human and equine isolates belonging to the same multilocus sequence typing lineage Universidade Federal do Rio de Janeiro, Instituto de Microbiologia Paulo de Gó es, RJ, Brazil Streptococcus dysgalactiae subsp. equisimilis (SDSE) isolates are the most common group C streptococci in humans and reports of invasive infections associated with SDSE have been increasing. Molecular epidemiology studies are an important strategy to trace the emergence and spread of possible well-fit bacterial pathogens of humans and animals. In this work, we analysed the antimicrobial and clonal profiles of 115 SDSE infection and colonization isolates of human and equine origin. PFGE revealed the spread of two main clusters: clone A (57.4 %) and clone A (26.1 %). Remarkably, two isolates from clone B obtained from human colonization cases displayed identical PFGE patterns to those of three equine infection isolates. In addition, multilocus sequence typing allocated these isolates to ST129 (CC31). All of the SDSE isolates were susceptible to penicillin, vancomycin, gentamicin, levofloxacin and chloramphenicol. Tetracycline and erythromycin resistance rates were 65.2 and 13.9 % respectively. Nevertheless, none of the isolates displaying sporadic PFGE patterns showed erythromycin resistance. The majority of erythromycin-resistant isolates from clone A had inducible resistance to macrolides, lincosamines and streptogramins B (iMLS B phenotype), which is associated with the presence of the ermA gene, whereas the resistant isolates from clone B showed the M phenotype, associated with the mefA gene. In conclusion, the data indicated that the analysed collection of SDSE isolates displayed a clonal structure and that the isolates found in human colonization cases could also be involved in equine infections. INTRODUCTIONStreptococcus dysgalactiae subsp. equisimilis (SDSE) has increasingly been recognized as the aetiological agent of several human invasive infections worldwide (Bruun et al., 2013;Sunaoshi et al., 2010;Takahashi et al., 2010Takahashi et al., , 2011Tsai et al., 2014). SDSE isolates are frequently classified as Lancefield group C or G. Comparative genomic analyses revealed that several commonly found group A streptococci virulence factors have also been detected in SDSE isolates, including C5a peptidase, M protein, glyceraldehyde 3-phosphate dehydrogenase, hyaluronidase, streptokinase, streptolysin O and streptolysin S, amongst others (Reissmann et al., 2012;Sunaoshi et al., 2010;Suzuki et al., 2011;Watanabe et al., 2013). Consequently, human infections related to SDSE resemble those associated with group A streptococci . These infections include pharyngitis, septic arthritis, pneumonia, bacteraemia, endocarditis, meningitis, streptococcal toxic shock-like syndrome, cellulitis and necrotizing fasciitis (Brandt & Spellerberg, 2009). Similar to group A streptococci, SDSE has also been linked to post-...

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“…Both group C and group G streptococci cause sporadic and epidemic pharyngitis that is clinically indistinguishable from GAS in school age children and in adults (13)(14)(15)(16). Early treatment may reduce the duration of symptoms, limit spread to susceptible contacts, and prevent invasive infections (17,18). A. haemolyticum causes pharyngitis primarily in adolescents and young adults presenting with clinical features that overlap those of GAS pharyngitis (11,19,20).…”

Section: Counterpointmentioning

confidence: 99%

“…Recently, we have shown that patients can collect their own throat swabs (and parents can collect their child's throat swab), yielding PCR results equivalent to those from health care workercollected swabs (18). As a result, we have incorporated the option of patient self-swabbing (or parental swabbing of children) into our process.…”

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confidence: 99%

Point-Counterpoint: A Nucleic Acid Amplification Test for Streptococcus pyogenes Should Replace Antigen Detection and Culture for Detection of Bacterial Pharyngitis

et al. 2016

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Nucleic acid amplification tests (NAATs) have frequently been the standard diagnostic approach when specific infectious agents are sought in a clinic specimen. They can be applied for specific agents such as S. pyogenes, or commercial multiplex NAATs for detection of a variety of pathogens in gastrointestinal, bloodstream, and respiratory infections may be used. NAATs are both rapid and sensitive. For many years, S. pyogenes testing algorithms used a rapid and specific group A streptococcal antigen test to screen throat specimens, followed, in some clinical settings, by a throat culture for S. pyogenes to increase the sensitivity of its detection. Now S. pyogenes NAATs are being used with increasing frequency. Given their accuracy, rapidity, and ease of use, should they replace antigen detection and culture for the detection of bacterial pharyngitis? Bobbi Pritt and Robin Patel of the Mayo Clinic, where S. pyogenes NAATs have been used for well over a decade with great success, will explain the advantages of this approach, while Richard (Tom) Thomson and Tom Kirn of the NorthShore University HealthSystem will discuss their concerns about this approach to diagnosing bacterial pharyngitis. POINT Acute pharyngitis is one of the most common diagnoses made in outpatient settings (1). Although viruses are responsible for the majority of cases, Streptococcus pyogenes (beta-hemolytic group A streptococci [GAS]) and, less commonly, other bacteria are estimated to cause 25% of the cases in adults and nearly 40% of the cases in children (2-4). Most cases of GAS pharyngitis are mild and self-limited, although potential complications include peritonsillar abscesses, otitis media, mastoiditis, cervical lymphadenitis, pneumonia, rheumatic fever, and poststreptococcal glomerulonephritis. Antimicrobial therapy may prevent these complications and may also shorten the duration of illness and potentially minimize the spread of infection to others; for these reasons, antibiotics are frequently administered, particularly to children and to adults with severe GAS pharyngitis (5, 6).We acknowledge that implicit in any diagnostic strategy is an assumption that results will be actionable, which, in the case of GAS pharyngitis, means that treatment would be administered. We realize that GAS pharyngitis, especially when it is nonsevere, is not universally treated and that there are geographic practice differences. There are a number of reasons for this, including that antibiotics have a relatively small effect in reducing symptoms and symptom duration, that rheumatic fever and poststreptococcal glomerulonephritis are rare in certain populations, that antibiotics risk disturbing the microbiome (and consequently increasing the risk of conditions such as thrush and Clostridium difficileassociated diarrhea), that antimicrobial use may result in allergies and other adverse drug effects, and also because of the associated cost and logistics of testing and treatment. Despite these controversies, which we will subsequently propose justify an outco...

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Adult Invasive and Noninvasive Infections Due to Streptococcus dysgalactiae subsp. equisimilis in France from 2006 to 2010

Cited by 54 publications

References 33 publications

Beta-haemolytic group A, C and G streptococcal infections in Western Norway: a 15-year retrospective survey

Beta-haemolytic group A, C and G streptococcal infections in Western Norway: a 15-year retrospective survey

Group C Streptococcus dysgalactiae subsp. equisimilis in south-east Brazil: genetic diversity, resistance profile and the first report of human and equine isolates belonging to the same multilocus sequence typing lineage

Point-Counterpoint: A Nucleic Acid Amplification Test for Streptococcus pyogenes Should Replace Antigen Detection and Culture for Detection of Bacterial Pharyngitis

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