Changing types of nephritogenic streptococci in Trinidad

Abstract

A B STRA CT The relation of seven different M types of streptococci to acute glomerulonephritis associated with skin lesions in South Trinidad has been studied by means of type-specific antibody assays as well as by isolation and identification of the strains. The data indicate that, one after another, five of these strains have prevailed among patients with acute glomerulonephritis during the past five years. At least three of the strains (M-types 55, 49, 57, and/or 60) were associated with epidemic increases in nephritis cases. The appearance of five consecutively predominant types of nephritogenic streptococci during a relatively short period of time is in contrast to the continuing prevalence of M-type 12 strains among nephritogenic streptococci primarily associated with respiratory infections in temperate zones. These observations suggest that the skin sores commonly found on children in tropical Trinidad, provide a particularly suitable environment for development of nephritogenic types. It remains to be seen whether these types will recur or whether new types will continue to emerge in Trinidad.

Acute Post-Streptococcal Glomerulonephritis in the Northern Territory of Australia: A Review of 16 Years Data and Comparison with the Literature

“…20,35 Emm 68.2, emm 91.0, emm 98.1, and emm 105.0 GAS have not previously been reported in association with APSGN, although it is possible that these more recently described types were not able to be identified by the serotyping methods used in older studies.…”

The Current State of Poststreptococcal Glomerulonephritis

“…5 Despite the reduction in worldwide incidence of PSGN, epidemics and clusters of cases of PSGN continue to appear. Table 1 lists epidemics with Ͼ100 cases 10,[15][16][17][18][19][20][21][22][23][24] and Table 2 the epidemics with Ͻ100 cases or clusters in families or communities. 9,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] Figure 1 shows that in the past 30 yr, large epidemics have been reported in countries in the middle range of the Human Development Index (HDI; between the 48th and the 87th rank place out of 177) and clusters of cases in countries in the upper 10% of the HDI.…”

“…Acute postinfectious glomerulonephritis is frequently the cause of severe acute renal failure (requiring dialysis and/or admission to pediatric intensive care units) in underdeveloped countries. The proportion of cases of acute renal failure that correspond to acute postinfectious glomerulonephritis of demonstrated or assumed poststreptococcal etiology is 13% in New Delhi, 44 30% in Istanbul, 45 51.6% in Casablanca, 46 4.6% in Lagos, 47 27% in Bombay, 48 19.2% in Lucknow, 49 33% in Asunció n, 50 17.4% in Chandrigarth, 51 5.2% in Lima, 52 9.3% in Varanasi, 53 and 25% in Osun State, Nigeria. 54 …”

Streptococcal antibodies in patients with burn injuries

“…Thus the anti-MAP and type-specific antibody responses after throat infection with opacityfactor positive M types is usually poor compared with opacity-factor negative types, presumably due to the poor antigenicity of some M proteins (Widdowson et al 1974). The type-specific antibody response after skin infection seems to be rather poor and occurs infrequently (Widdowson et al 1974;Potter et al 1971;Dillon et al 1979). Patients with streptococcal pyoderma have considerably lower titres of ASO than do patients with streptococcal sore throat, but titres of antiDNAase B are often very high in cases of skin infection (Anthony, Perlman & Wannamaker, 1967;Dillon & Reeves, 1969).…”