Changes in the pattern of infection caused byStreptococcus pyogenes

Abstract

The distribution of T- and M-protein antigens was determined in 12,469 cultures of Streptococcus pyogenes sent to a reference laboratory. Of these 7232 (58%) were isolates from hospital patients, 249 (2%) from hospital staff and 4988 (40%) from the community. The survey extended from January 1980 to June 1987. During this time the numbers of isolates of M-types 6, 49 and 81 rose then fell, being replaced by types 1, 3 and 28. The proportion of isolates of M-types 4 and 12 remained constant. Few strains were received from cases of nephritis or rheumatic fever but there has been an increase in the number of strains from serious infections and deaths. Forty-four of the 55 (80%) strains received since 1985 from fatal infections have belonged to M-type 1. All other strains, bar two, received from fatal infections in those years belonged to M-type 3. Representatives of M-type 1 were also associated with erysipelas. Types 3 and 4 predominated among the isolates from scarlet fever, types 1, 4, 12 and 49 from nephritis, types 49 and 81 from skin infections in meat workers and type 28 in cases of puerperal sepsis. The M-typability rate was 97% but new M antigens await definition among strains causing pyoderma.

Binding of IgA and/or IgG is a common property among clinical isolates of group A streptococci

“…Among the 31 septicaemia strains studied here, seven were isolated during a 7-month period from October 1988 to April 1989, and all of these strains were of type Ti. These data are in agreement with reports that septicaemias and other severe infections due to group A streptococci type Ti have recently increased in frequency in both Great Britain and Scandinavia [3,14]. Most of these Ti strains were IgG-binders, but the binding observed was of low magnitude (about 20 % in the type of test used for Fig.…”

“…The recent outbreaks of rheumatic fever in the United States [1], and the reappearance of severe infections associated with a toxic shock-like syndrome [2,3], have caused a renewed interest in infections caused by group A steptococci and in the extracellular proteins produced by these bacteria. Among such proteins, particular attention has been given to the scarlet fever toxins as well as to the M proteins, the antiphagocytic fibrils extending from the bacterial cell surface [4].…”

Clonal structure of invasiveStreptococcus pyogenesin Northern Scotland

“…Forty-seven percent of deaths associated with S. pyogenes infections in the United Kingdom in recent years have been caused by M type 1 strains [12]. The close correlation between DNA restriction fragment profile and serotype [131 suggests that these strains may belong to the ET1 /ET2/I clone or group of clones, a conclusion strengthened by the work of Musser and colleagues [14].…”

Clonal diversity ofStreptococcus pyogeneswithin some M-types revealed by multilocus enzyme electrophoresis

“…Severe streptococcal infections occur in many countries [1][2][3][4][5][6][7]. Important sequelae of streptococcal infections include toxic shock-like syndrome (TSLS), rheumatic fever (RF) and acute poststreptococcal glomerulonephritis (APSGN).…”