First human case report of sepsis due to infection with Streptococcus suis serotype 31 in Thailand

Abstract

Background: Streptococcus suis is a zoonotic pathogen that causes invasive infections in humans and pigs. It has been reported that S. suis infection in humans is mostly caused by serotype 2. However, human cases caused by other serotypes have rarely been reported. This is the first report of a human case of infection with S. suis serotype 31 in Thailand. Case presentation: A 55-year-old male alcohol misuser with liver cirrhosis was admitted with sepsis to a hospital in the Central Region of Thailand. He had consumed a homemade, raw pork product prior to the onset of illness. He was alive after treatment with ceftriaxone and no complication occurred. An isolate from blood culture at the hospital was suspected as viridans group Streptococcus. It was confirmed at a reference laboratory as S. suis serotype 31 by biochemical tests, 16S rDNA sequencing, and multiplex polymerase chain reaction for serotyping, but it was untypable by the co-agglutination test with antisera against recognized S. suis serotypes, suggesting loss of capsular material. The absence of a capsule was confirmed by transmission electron microscopy. The isolate was confirmed to be sequence type 221, with 13 putative virulence genes that are usually found in serotype 2 strains. Conclusion: We should be aware of the emergence of S. suis infections caused by uncommon serotypes in patients with predisposing conditions. Laboratory capacity to identify S. suis in the hospital is needed in developing countries, which can contribute to enhanced surveillance, epidemiological control, and prevention strategies in the prevalent area.

Human infection caused by Streptococcus suis serotype 2 in China: report of two cases and epidemic distribution based on sequence type

“…Human infection caused by S. suis is a rare but lifethreatening condition. Epidemic and sporadic human infection cases caused by S. suis serotype 1, 2, 4, 5, 9, 14, 16, 21, 24 and 31 have also been reported in many countries and 17.8% of patients dead [1,[8][9][10].Timely and accurate diagnosis of pathogenic bacteria is the key to cure. Because of the variable of biochemical characteristics, S. suis is often misidentified as other species of Streptococcus genus [7].…”

Genotypic Comparison between Streptococcus suis Isolated from Pigs and Humans in Thailand

“…Currently, 29 serotypes of S. suis are recognized [4]. Of these, serotype 2 is the most prevalent in S. suis human infections, although cases have also been reported caused by serotypes 4,5,9,14,16,21,24, and 31 [1][2][3][5][6][7][8][9].…”

Tools for Molecular Epidemiology of Streptococcus suis

“…Hence, currently there are 29 true S. suis serotypes. Of them, serotype 2 is the most prevalent in both human and pig infections although cases caused by serotypes 4,5,9,14,16,21,24, and 31 have also been reported [1][2][3][4][14][15][16][17]. A first study reported that a variant of the serum opacity factor (ofs) can serve as a genetic marker to determine CCs of S. suis [39].…”