Abstract
A nationwide laboratory-based surveillance study of invasive S. pyogenes infections was conducted in Germany. Invasive isolates (n = 719) were obtained between 2009 and 2014. Most isolates were obtained from blood (92.1%). The proportions of isolates from cerebrospinal fluid, pleural fluid, synovial fluid and peritoneal fluid were 3.9%, 1.8%, 1.7% and 0.6%, respectively. The most common emm types were emm 1 (31.8%), emm 28 (15.4%) and emm 89 (14.5%). The most common superantigen genes (speA, speC, speG, speH, speI, speJ, speK, speL, speM, ssa) identified from S. pyogenes were speG (92.1%), speJ (50.9%), and speC (42.0%). Significant associations of superantigen genes with underlying conditions or risks were observed in speG, speH, speJ, and speK. Significant associations between emm types or superantigen genes with clinical complications were observed in emm type 3 and in superantigen gene speA 1–3. Most frequent clinical manifestations included sepsis 59.4%, STSS 6.3%, meningitis 5.4%, and necrotizing fasciitis 5.0% (significantly associated with emm1).
Highlights
Streptococcus pyogenes (Lancefield group A streptococcus; GAS) is a major human pathogen and responsible for a wide range of both suppurative and non-suppurative diseases, e.g. pharyngitis, erysipelas, septicaemia, meningitis, pneumonia and the notably severe manifestations necrotising fasciitis (NF) and streptococcal toxic shock syndrome (STSS)
Invasive infections caused by S. pyogenes have been reported increasingly since the mid- to late 1980s [2], and recent upsurges in iGAS infections were reported from England [3], Ireland [4, 5] and Sweden [6]
For each emm type and each superantigen, we investigated the possible influence on each outcome parameter
Summary
Streptococcus pyogenes (Lancefield group A streptococcus; GAS) is a major human pathogen and responsible for a wide range of both suppurative and non-suppurative diseases, e.g. pharyngitis, erysipelas, septicaemia, meningitis, pneumonia and the notably severe manifestations necrotising fasciitis (NF) and streptococcal toxic shock syndrome (STSS). Suppurative infections and post-infection sequelae, e.g. acute rheumatic fever, rheumatic heart disease and glomerulonephritis, result in substantial human morbidity [1]. Invasive infections caused by S. pyogenes (iGAS) have been reported increasingly since the mid- to late 1980s [2], and recent upsurges in iGAS infections were reported from England [3], Ireland [4, 5] and Sweden [6]. The global burden of invasive S. pyogenes disease is high, and there are estimated to be at least 663,000 new cases and 163,000 deaths worldwide each year.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
