Community-Acquired Group A Streptococcal Deaths in Los Angeles County

Jc, Thomas; Sj, Carr; Fujioka, Kei; Sh, Waterman

doi:10.1093/infdis/160.6.1086

Cited by 30 publications

(5 citation statements)

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“…It appears from the results of this and several other studies that speA is usually associated with group A streptococcal strains isolated from patients with severe invasive disease. Because this pyrogenic exotoxin may not always be present in isolates from patients with severe invasive disease, other risk factors including those of the host are also likely to be important (34,38).…”

Section: Discussionmentioning

confidence: 99%

Streptococcal erythrogenic toxin genes: detection by polymerase chain reaction and association with disease in strains isolated in Canada from 1940 to 1991

Tyler¹,

Johnson²,

Huang³

et al. 1992

J Clin Microbiol

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The presence of genes encoding pyrogenic exotoxins type A (spe4), B (speB), and C (speC) and streptolysin 0 (slo) was determined by the polymerase chain reaction (PCR) to target specific sequences in 152 strains of group A streptococci. These included reference strains, representative M and T type strains, and strains associated with scarlet fever and pharyngitis collected between 1940 to 1991 and included strains from patients with severe invasive streptococcal infections. PCR amplicons were detected by agarose gel electrophoresis, and specificity was established by restriction fragment analysis. The frequency of occurrence for each target gene among all strains tested was 33.6% for speA, 99.3% for speB, 28.9%1o for speC, and 100% for slo. Strains of non-group A streptococci, recognized toxigenic bacterial pathogens, and pneumolysin-producing Streptococcus pneumoniae strains were negative for all targeted gene sequences. Detection limits in the PCR were found to be 100 pg of total nucleic acids for the speB and speC genes and 1 ng for the speA and slo genes. Isolates associated with scarlet fever, pharyngitis, and severe invasive infections showed statistically significant differences in the presence of speA, with scarlet fever strains having the highest association (81.3%), severe infections the next highest association (42.9%o), and pharyngitis the lowest association (18.4%). Although no significant differences were observed in speC frequencies in isolates associated with the three disease categories, a genotype of speB slo was significantly higher in isolates associated with pharyngitis (54.1%) than in strains associated with scarlet fever (18.8%) or severe invasive disease (23.8%). Streptolysin 0 targets were present in all of the isolates tested, and only a single strain (T-11-M-11) was devoid of targeted speB sequences, thereby demonstrating that neither speB nor slo is associated with any particular clinical presentation.

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Section: Discussionmentioning

confidence: 99%

Streptococcal erythrogenic toxin genes: detection by polymerase chain reaction and association with disease in strains isolated in Canada from 1940 to 1991

Tyler¹,

Johnson²,

Huang³

et al. 1992

J Clin Microbiol

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“…These infections have been termed streptococcal toxic-shock syndrome (TSS; Table 1) (19). Persons of all ages are affected; most do not have predisposing underlying diseases (11,(20)(21)(22)(23)(24)(25).…”

Section: Acute Life-threatening Group a Streptococcal Infections Strementioning

confidence: 99%

Streptococcal Toxic Shock Syndrome: Synthesis of Tumor Necrosis Factor and Interleukin-1 by Monocytes Stimulated with Pyrogenic Exotoxin A and Streptolysin O

Hackett

Stevens²

1992

Journal of Infectious Diseases

183

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“…Recently, severe invasive GAS infections associated with shock and organ failure have been reported with increasing frequency, predominantly from North America and Europe (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). These infections have been termed streptococcal toxic-shock syndrome (TSS; Table 1) (19). Persons of all ages are affected; most do not have predisposing underlying diseases (11,(20)(21)(22)(23)(24)(25).…”

Section: Streptococcal Tssmentioning

confidence: 99%

1356

Rane

Bañas²,

Aggarwal

et al. 2013

Critical Care Medicine

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Since the 1980s there has been a marked increase in the recognition and reporting of highly invasive group A streptococcal infections with or without necrotizing fasciitis associated with shock and organ failure. Such dramatic cases have been defined as streptococcal toxic-shock syndrome. Strains of group A streptococci isolated from patients with invasive disease have been predominantly M types 1 and 3 that produce pyrogenic exotoxin A or B or both. In this paper, the clinical and demographic features of streptococcal bacteremia, myositis, and necrotizing fasciitis are presented and compared to those of streptococcal toxic-shock syndrome. Current concepts in the pathogenesis of invasive streptococcal infection are also presented, with emphasis on the interaction between group A Streptococcus virulence factors and host defense mechanisms. Finally, new concepts in the treatment of streptococcal toxic-shock syndrome are discussed.

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Community-Acquired Group A Streptococcal Deaths in Los Angeles County

Cited by 30 publications

References 0 publications

Streptococcal erythrogenic toxin genes: detection by polymerase chain reaction and association with disease in strains isolated in Canada from 1940 to 1991

Streptococcal erythrogenic toxin genes: detection by polymerase chain reaction and association with disease in strains isolated in Canada from 1940 to 1991

Streptococcal Toxic Shock Syndrome: Synthesis of Tumor Necrosis Factor and Interleukin-1 by Monocytes Stimulated with Pyrogenic Exotoxin A and Streptolysin O

1356

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