Clinical and Microbiological Characteristics of Severe Group A Streptococcal Infections in Italy

Hunolstein, Christina von; Suligoi, Barbara; Pataracchia, Marco; Scopetti, F; Recchia, Simona; Greco, Donato; Orefici, Graziella

doi:10.1007/978-1-4899-1825-3_20

Cited by 8 publications

(8 citation statements)

References 6 publications

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“…It may be assumed that such cases have occurred throughout the continent. Early reports in Europe [22,24,33] were associated with transient peaks of invasive S. pyogenes serotype M1 infection and, although strains of this type, together with serotypes M3, M12 and R28, have remained frequent [6,24,36] (as in this report), a variety of other serotypes has also been encountered in patients with TSS in most centers. Isolates of serotypes M1 and M3 very often carry the genes for toxin A [34,35], but SPE gene findings have been variable in strains of other serotypes [8,24,34].…”

Section: Discussionmentioning

confidence: 56%

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

Barnham¹,

Weightman

Anderson

et al. 2002

Clinical Microbiology and Infection

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Section: Discussionmentioning

confidence: 56%

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

Barnham¹,

Weightman

Anderson

et al. 2002

Clinical Microbiology and Infection

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“…Strain HC01 was previously isolated from a patient with endocarditis who was refractory to PEN treatment (de Mattos-Guaraldi & Formiga, 1998). The possibility of PEN tolerance was observed previously for non-toxigenic C. diphtheriae strains, a phenomenon not observed for ERY (von Hunolstein et al, 2002). Additionally, refractivity to endocarditis treatment has been related to the Eagle effect (paradoxical bactericidal effect), an aspect observed previously for C. diphtheriae endocarditis isolates (Grandière-Pérez et al, 2005), and which is under investigation with Brazilian endocarditis isolates.…”

Section: Resultsmentioning

confidence: 62%

SubMICs of penicillin and erythromycin enhance biofilm formation and hydrophobicity of Corynebacterium diphtheriae strains

Gomes

Peixoto

Barbosa

et al. 2013

Journal of Medical Microbiology

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Subinhibitory concentrations (subMICs) of antibiotics may alter bacterial surface properties and change microbial physiology. This study aimed to investigate the effect of a subMIC (F MIC) of penicillin (PEN) and erythromycin (ERY) on bacterial morphology, haemagglutinating activity, cellsurface hydrophobicity (CSH) and biofilm formation on glass and polystyrene surfaces, as well as the distribution of cell-surface acidic anionic residues of Corynebacterium diphtheriae strains (HC01 tox " strain; CDC-E8392 and 241 tox + strains). All microorganisms tested were susceptible to PEN and ERY. Growth in the presence of PEN induced bacterial filamentation, whereas subMIC of ERY caused cell-size reduction of strains 241 and CDC-E8392. Adherence to human erythrocytes was reduced after growth in the presence of ERY, while CSH was increased by a subMIC of both antibiotics in bacterial adherence to n-hexadecane assays. Conversely, antibiotic inhibition of biofilm formation was not observed. All strains enhanced biofilm formation on glass after treatment with ERY, while only strain 241 increased glass adherence after cultivation in the presence of PEN. Biofilm production on polystyrene surfaces was improved by F MIC of ERY. After growth in the presence of both antimicrobial agents, strains 241 and CDC-E8392 exhibited anionic surface charges with focal distribution. In conclusion, subMICs of PEN and ERY modified bacterial surface properties and enhanced not only biofilm formation but also cell-surface hydrophobicity. Antibiotic-induced biofilm formation may contribute to the inconsistent success of antimicrobial therapy for C. diphtheriae infections. Penicillin (PEN) and erythromycin (ERY) have long been used as drugs of choice for the eradication of toxin-producing

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“…The speArestricted emm types such as emm-1 and emm-3 strains were more representative in invasive strains (von Hunolstein et al, 1997) and were macrolide susceptible. Antibiotic resistance in invasive strains was mostly related to emm-89/erm(B)-resistant strains (Orefici et al, 2003) (Table 1).…”

Section: Resultsmentioning

confidence: 99%

Association of group A streptococcal emm types with virulence traits and macrolide-resistance genes is independent of the source of isolation

Creti

Gherardi

Imperi

et al. 2005

Journal of Medical Microbiology

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Streptococcus pyogenes (group A streptococci; GAS) recovered from paediatric pharyngitis (101 isolates) and asymptomatic children (79 isolates) in the same geographical area and period, as well as isolates collected during an enhanced national surveillance programme for GAS invasive diseases (79 isolates), were screened for the incidence of the streptococcal pyrogenic exotoxin (spe) genes speA and speC, as well as the macrolide-resistance genes erm(B), erm(A) subclass erm(TR) and mef(A), and typed by emm sequencing. The speA gene was detected with comparable incidence among throat isolates (13 . 9 % of asymptomatic children and 16 . 8 % of pharyngitis isolates) and in 25 % of invasive cases; in contrast, speC incidence was, surprisingly, higher in paediatric populations (55 . 4 % in pharyngitis isolates and 65 . 8 % in asymptomatic children) than in invasive isolates (30 %; P , 0 . 0001). Macrolide resistance was detected in 26 . 6, 38 . 0 and 37 . 6 % of strains belonging to invasive, asymptomatic and pharyngitis populations, respectively. The different incidences of exotoxin and antibiotic-resistance genes among populations did not appear to have an intrinsic clinical significance, but may reflect the propensity of these traits to be associated with certain emm types independent of the source from which the strains were isolated. Further investigations with larger emm-type populations are warranted to confirm this. INTRODUCTIONThe virulence of Streptococcus pyogenes (group A streptococci; GAS) is determined by a variety of structural molecules, enzymes and toxins. In particular, phage-encoded exotoxins, of which SpeA and SpeC are the first to have been described and studied, seem to play a critical role in the emergence of unusually virulent clones by horizontal gene transfer (Banks et al., 2002). Besides virulence traits, antibiotic resistance, in particular to macrolides, can enhance bacterial fitness and be responsible for treatment failure (Freeman & Shulman, 2002).The aim of the present study was to investigate whether particular virulent clones, both antibiotic-resistant and exotoxin 'producers', were related to a particular disease. To this end, the presence of speA, speC and macrolide-resistance erm(B), erm(A) subclass erm(TR) and mef(A) genes was investigated in GAS strains collected in the same geographical area and time period from paediatric pharyngitis cases (101 isolates) (Dicuonzo et al., 2001(Dicuonzo et al., , 2002 or throat swabs of asymptomatic children (79 isolates) (Cardona & Orefici, 2000;Creti et al., 2004), as well as in isolates obtained during an enhanced national surveillance programme for GAS invasive diseases (79 isolates, mean patient age 47 . 1 AE 23 . 6 years) (Suligoi et al., 1998;von Hunolstein et al., 1997). METHODSBacterial growth conditions. Bacteria were grown on 5 % defibrinated sheep blood agar plates at 37 8C in 5 % CO 2 overnight.DNA isolation and PCR. Total bacterial DNA was prepared by a Abbreviation: GAS, group A streptococci. Chelex-based procedure using an InstaG...

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Clinical and Microbiological Characteristics of Severe Group A Streptococcal Infections in Italy

Cited by 8 publications

References 6 publications

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

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

SubMICs of penicillin and erythromycin enhance biofilm formation and hydrophobicity of Corynebacterium diphtheriae strains

Association of group A streptococcal emm types with virulence traits and macrolide-resistance genes is independent of the source of isolation

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