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© Research
Publication : Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases

Invasive group A streptococcal infections in adults, France (2006-2010)

Scientific Fields
Diseases
Organisms
Applications
Technique

Published in Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases - 29 Aug 2011

Plainvert C, Doloy A, Loubinoux J, Lepoutre A, Collobert G, Touak G, Trieu-Cuot P, Bouvet A, Poyart C,

Link to Pubmed [PMID] – 21883669

Clin. Microbiol. Infect. 2012 Jul;18(7):702-10

Severe invasive group A streptococcal diseases have re-emerged during the past 10-20 years. In order to provide a better insight into the current epidemiological situation in France, we analysed the questionnaires regarding all invasive strains received at the National Reference Center for Streptococci (CNR-Strep) between 2006 and 2010 from patients aged ≥ 18 and characterized them by emm typing, spe gene detection and antibiotic resistance. Among the 1542 invasive GAS strains studied, 78% (n=1206) were from blood cultures, and a streptococcal toxic shock syndrome (STSS) was described in 22% (n=340) of cases, mainly associated with necrotizing fasciitis (NF) and pleuro-pulmonary infections (p<0.001). The in-hospital fatality rate was 15%. A total of 83 different emm types were recovered but the three predominant emm types, representing almost 60% of the isolates, were emm1 (24%), emm28 (17%) and emm89 (15%). The preponderance of each emm type varied according to the year, with a significant constant increase of emm28 strains, whereas emm1 strains, representing approximately 32% of GAS invasive isolates in 2007 and 2008, dropped to <15% in 2010 (p<0.001). The distribution of phage-associated superantigen genes (speA, speC and ssa) was linked to certain emm types. Between 2006 and 2010, the percentage that was macrolide-resistant decreased from 11% to 5%, confirming the trend observed in 2007. Fortunately, emm1 strains associated with the most life-threatening clinical manifestations remain susceptible to all anti-streptococcal antibiotics.

http://www.ncbi.nlm.nih.gov/pubmed/21883669