Streptococcal toxic shock syndrome: a description of 14 cases from North Yorkshire, UK

Barnham, M.; Weightman, N.C.; Anderson, A. W.; Tanna, Asha

doi:10.1046/j.1469-0691.2002.00396.x

Cited by 58 publications

(56 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…), the causative bacteria in six cases were identified as S. dysgalactiae subsp. equisimilis (2,27,38) and S. equisimilis (24,45), which was renamed as S. dysgalactiae subsp. equisimilis according to the latest classification (47,48), while other reports did not identify the species of the causative bacteria.…”

Section: Discussionmentioning

confidence: 99%

“…Since then the number of patients of this serious infectious disease has been increasing in North America, Europe, and other parts of the world (2,10,18,21,34). The Working Group on Severe Streptococcal Infections suggested a case definition of streptococcal toxic shock syndrome (STSS) and necrotizing fasciitis (52).…”

mentioning

confidence: 99%

“…Recently, case reports referring to STSS caused by the Lancefield group C streptococci (GCS and G i and GGS, respectively) have also accumulated (1,2,11,14,17,24,27,30,35,38,45,49; H. Watanabe (ed. ), Rep. 24th Hyg.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Characterization of Group C and G Streptococcal Strains That Cause Streptococcal Toxic Shock Syndrome

Hashikawa

Iinuma

Furushita³

et al. 2004

J Clin Microbiol

164

122

View full text Add to dashboard Cite

Twelve strains (the largest number ever reported) of group C and G 1 streptococci (GCS and GGS, respectively) that caused streptococcal toxic shock syndrome (STSS) were collected and characterized. Eleven strains were identified as Streptococcus dysgalactiae subsp. equisimilis, and one strain was identified as Streptococcus equi subsp. zooepidemicus. We found that it was the first reported case of STSS caused by S. equi subsp. zooepidemicus. Cluster analysis according to the 16S rRNA gene (rDNA) sequences revealed that the S. dysgalactiae strains belonged to clusters I and II, both of which were closely related. The emm types and the restriction patterns of chromosomal DNA measured by pulsed-field gel electrophoresis were highly variable in these strains except BL2719 and N1434. The 16S rDNA sequences and other characteristics of these two strains were indistinguishable, suggesting the clonal dissemination of this particular S. dysgalactiae strain in Japan. As the involvement of superantigens in the pathogenesis of group A streptococcus-related STSS has been suggested, we tried to detect known streptococcal superantigens in GCS and GGS strains. However, only the spegg gene was detected in seven S. dysgalactiae strains, with none of the other superantigen genes being detected in any of the strains. However, the sagA gene was detected in all of the strains except Tokyo1291. In the present study no apparent factor(s) responsible for the pathogenesis of STSS was identified, although close genetic relationships of GCS and GGS strains involved in this disease were suggested.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Characterization of Group C and G Streptococcal Strains That Cause Streptococcal Toxic Shock Syndrome

Hashikawa

Iinuma

Furushita³

et al. 2004

J Clin Microbiol

164

122

View full text Add to dashboard Cite

show abstract

“…equisimilis strains having group A antigen rather than group C or G antigen have also been reported (Bert & Lambert-Zechovsky, 1997;Brandt et al, 1999;Katsukawa et al, 2002). Many recent studies have reported that this organism causes invasive and systemic streptococcal infections like GAS (Natoli et al, 1996;Wagner et al, 1996; Hirose et al, 1997; Kugi et al, 1998;Barnham et al, 2002;Cohen-Poradosu et al, 2004;Hashikawa et al, 2004). The organism has also been reported to cause a wide variety of human infections such as pharyngitis, cellulitis, sepsis, meningitis and endocarditis (Woo et al, 2001).…”

Section: Introductionmentioning

confidence: 97%

Molecular emm genotyping and antibiotic susceptibility of Streptococcus dysgalactiae subsp. equisimilis isolated from invasive and non-invasive infections

Sunaoshi

Murayama

Adachi

et al. 2010

Journal of Medical Microbiology

View full text Add to dashboard Cite

To analyse the characteristics of infections caused by Streptococcus dysgalactiae subsp. equisimilis, clinical isolates (n5145) were collected at 11 medical institutions between September 2003 and October 2005. These isolates belonged to Lancefield group A (n55), group C (n518) or group G (n5122). Among all isolates, 42 strains were isolated from sterile samples such as blood, synovial fluid and tissue specimens from patients who were mostly over 50 years with invasive infections, and included seven cases of streptococcal toxic shock syndrome and necrotizing fasciitis. In contrast, the remaining 103 were isolated mainly from patients of all age groups with non-invasive infections such as pharyngotonsillitis. These isolates were classified into 25 types based on emm genotyping. A significant difference in emm types was observed between isolates from invasive and non-invasive infections (P,0.001): stG485, stG6792 and stG2078 predominated among isolates from invasive infections. A phylogenetic tree of complete open reading frames of emm genes in this organism showed high homology with those of Streptococcus pyogenes, but not with those of other streptococci. The presence of five different clones was estimated based on DNA profiles of isolates from invasive infections obtained by PFGE. Genes for resistance to macrolides [erm(A), three isolates; erm(B), five isolates; mef(A), seven isolates] and levofloxacin (mutations in gyrA and parC, four isolates) were identified in this organism. These results suggest the need for further nationwide surveillance of invasive infections caused by S. dysgalactiae subsp. equisimilis. INTRODUCTIONMost b-haemolytic streptococcal pathogens isolated from humans are identified as Streptococcus pyogenes (group A streptococci; GAS), Streptococcus agalactiae (group B streptococci; GBS), Streptococcus dysgalactiae subsp. equisimilis and species of the anginosus group that belong to Lancefield groups A, B, C, G or F (Facklam, 2002;Ruoff et al., 2003). In contrast to GAS and GBS, which are known to cause serious and systemic invasive infections, streptococci with Lancefield group C or G antigens were long considered to be commensal organisms that only rarely caused invasive infections as opportunistic pathogens.In 1996, S. dysgalactiae subsp. equisimilis was proposed as a new streptococcal taxon (Vandamme et al., 1996). Although rare, S. dysgalactiae subsp. equisimilis strains having group A antigen rather than group C or G antigen have also been reported (Bert & Lambert-Zechovsky, 1997;Brandt et al., 1999;Katsukawa et al., 2002 Notably, S. dysgalactiae subsp. equisimilis possesses many virulence factors shared with GAS, such as M protein (Fischetti, 1989; Schnitzler et al., 1995), streptolysin O (Gerlach et al., 1993Okumura et al., 1994), streptolysin S (Humar et al., 2002 and streptokinase (Walter et al., 1989;Ikebe et al., 2004). It has been suggested that these factors were transmitted from GAS to this species (Kalia et al., 2001).In the present report, we have described S. dysgalactiae ...

show abstract

“…20 Both leukocytosis and leukopenia have been described in NF, the latter possibly due to depletion of circulating white cells sequestered in peripheral tissues. 1,12 Isolation of Streptococcus spp. from either a sterile or a nonsterile site of the body coupled with 2 or more clinical signs is required to confirm the diagnosis.…”

mentioning

confidence: 99%

Fatal Necrotizing Fasciitis and Myositis in a Captive Common Bottlenose Dolphin (Tursiops Truncatus) Associated with Streptococcus Agalactiae

Zappulli¹,

Mazzariol²,

Cavicchioli³

et al. 2005

J VET Diagn Invest

View full text Add to dashboard Cite

Abstract.A common bottlenose dolphin (Tursiops truncatus) was presented for necropsy after acute onset of gastrointestinal signs and cutaneous lesions that rapidly progressed to death. Gross and microscopic findings were characterized by locally extensive severe necrohemorrhagic fasciitis and cellulitis, and severe necrotizing myositis in the head and dorsocranial thorax, with numerous disseminated gram-positive cocci. Streptococcus agalactiae was isolated from the lesions and from visceral organs (liver and lung), and it was identified by standard microbiology techniques. This communication is the first report of necrotizing fasciitis in a marine mammal associated with S. agalactiae.

show abstract

Streptococcal toxic shock syndrome: a description of 14 cases from North Yorkshire, UK

Cited by 58 publications

References 41 publications

Characterization of Group C and G Streptococcal Strains That Cause Streptococcal Toxic Shock Syndrome

Characterization of Group C and G Streptococcal Strains That Cause Streptococcal Toxic Shock Syndrome

Molecular emm genotyping and antibiotic susceptibility of Streptococcus dysgalactiae subsp. equisimilis isolated from invasive and non-invasive infections

Fatal Necrotizing Fasciitis and Myositis in a Captive Common Bottlenose Dolphin (Tursiops Truncatus) Associated with Streptococcus Agalactiae

Contact Info

Product

Resources

About