A Cluster of Ecthyma Outbreaks Caused by a Single Clone of Invasive and Highly Infective<i>Streptococcus pyogenes</i>

Wasserzug, Oshri; Valinsky, Lea; Klement, Eyal; Bar‐Zeev, Yael; Davidovitch, Nadav; Orr, Nadav; Korenman, Zinaida; Kayouf, Raid; Sela, Tamar; Ambar, Ruhama; Derazne, Estela; Dagan, Ron; Zarka, Salman

doi:10.1086/597770

Cited by 47 publications

(24 citation statements)

References 22 publications

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“…PFGE analysis showed clones isolated from Israel and our collections have similar band patterns (data not shown), suggesting this particular clone has spread to different geographic regions around the world. 29 The rarely reported emm types, including emm13, emm81, and emm106, were not only significantly associated with invasive diseases but also more prevalent among patients older than 50 years. The lack of the immune functional analysis for adult patients make it difficult to connect the correlation between rarely encountered emm types and invasive diseases directly.…”

Section: Discussionmentioning

confidence: 92%

Emergence of uncommon emm types of Streptococcus pyogenes among adult patients in southern Taiwan

Chiang-Ni

Liu

et al. 2011

Journal of Microbiology, Immunology and Infection

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Section: Discussionmentioning

confidence: 92%

Emergence of uncommon emm types of Streptococcus pyogenes among adult patients in southern Taiwan

Chiang-Ni

Liu

et al. 2011

Journal of Microbiology, Immunology and Infection

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“…Small-scale localized outbreaks of GAS pharyngitis have been described in the literature and appear to occur as a result of transmission of a GAS strain to susceptible individuals through either a common source or, particularly in crowded settings, person-to-person spread. Examples include outbreaks in military training centers as a result of crowding (93,94), multiple outbreaks following consumption of contaminated foods (95)(96)(97)(98)(99)(100)(101)(102), and hospital-acquired puerperal sepsis outbreaks (22)(23)(24).…”

Section: Outbreaks Of Gas Diseasesmentioning

confidence: 99%

Disease Manifestations and Pathogenic Mechanisms of Group A Streptococcus

et al. 2014

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SUMMARY Streptococcus pyogenes , also known as group A Streptococcus (GAS), causes mild human infections such as pharyngitis and impetigo and serious infections such as necrotizing fasciitis and streptococcal toxic shock syndrome. Furthermore, repeated GAS infections may trigger autoimmune diseases, including acute poststreptococcal glomerulonephritis, acute rheumatic fever, and rheumatic heart disease. Combined, these diseases account for over half a million deaths per year globally. Genomic and molecular analyses have now characterized a large number of GAS virulence determinants, many of which exhibit overlap and redundancy in the processes of adhesion and colonization, innate immune resistance, and the capacity to facilitate tissue barrier degradation and spread within the human host. This improved understanding of the contribution of individual virulence determinants to the disease process has led to the formulation of models of GAS disease progression, which may lead to better treatment and intervention strategies. While GAS remains sensitive to all penicillins and cephalosporins, rising resistance to other antibiotics used in disease treatment is an increasing worldwide concern. Several GAS vaccine formulations that elicit protective immunity in animal models have shown promise in nonhuman primate and early-stage human trials. The development of a safe and efficacious commercial human vaccine for the prophylaxis of GAS disease remains a high priority.

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“…12,13 In addition, nonmenstrual TSS, sepsis, and other serious infectious diseases caused by these bacteria continue to pose substantial problems. 7,[14][15][16] Exposure to SAgs produced ex vivo by organisms growing in surgical tampons also can cause TSS. 17 Additional systemic diseases believed to be caused by SAgs and that share immunopathogenesis similar to TSS include Kawasaki disease 18 and neonatal TSS-like exanthematous disease, 19 among others.…”

mentioning

confidence: 99%

Human Leukocyte Antigen Class II Transgenic Mouse Model Unmasks the Significant Extrahepatic Pathology in Toxic Shock Syndrome

Tilahun

Marietta

et al. 2011

The American Journal of Pathology

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Among the exotoxins produced by Staphylococcus aureus and Streptococcus pyogenes, the superantigens (SAgs) are the most potent T-cell activators known to date. SAgs are implicated in several serious diseases including toxic shock syndrome (TSS), Kawasaki disease, and sepsis. However, the immunopathogenesis of TSS and other diseases involving SAgs are still not completely understood. The commonly used conventional laboratory mouse strains do not respond robustly to SAgs in vivo. Therefore, they must be artificially rendered susceptible to TSS by using sensitizing agents such as D-galactosamine (D-galN), which skews the disease exclusively to the liver and, hence, is not representative of the disease in humans. SAg-induced TSS was characterized using transgenic mice expressing HLA class II molecules that are extremely susceptible to TSS without D-galN. HLA-DR3 transgenic mice recapitulated TSS in humans with extensive multiple-organ inflammation affecting the lung, liver, kidneys, heart, and small intestines. Heavy infiltration with T lymphocytes (both CD4 ؉ and CD8؉), neutrophils, and macrophages was noted. In particular, the pathologic changes in the small intestines were extensive and accompanied by significantly altered absorptive functions of the enterocytes. In contrast to massive liver failure alone in the D-galN sensitization model of TSS, findings of the present study suggest that gut dysfunction might be a key pathogenic event that leads to high morbidity and mortality in humans with

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A Cluster of Ecthyma Outbreaks Caused by a Single Clone of Invasive and Highly InfectiveStreptococcus pyogenes

Abstract: Our study demonstrates the possible ramifications of the combination of a virulent and highly infective S. pyogenes strain and poor living conditions, and it emphasizes the importance of early intervention in such conditions.

Cited by 47 publications

References 22 publications

Emergence of uncommon emm types of Streptococcus pyogenes among adult patients in southern Taiwan

Emergence of uncommon emm types of Streptococcus pyogenes among adult patients in southern Taiwan

Disease Manifestations and Pathogenic Mechanisms of Group A Streptococcus

Human Leukocyte Antigen Class II Transgenic Mouse Model Unmasks the Significant Extrahepatic Pathology in Toxic Shock Syndrome

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