Group A Streptococcal Carriage and Seroepidemiology in Children up to 10 Years of Age in Australia

Marshall, Helen; Richmond, Peter; Nissen, Michael D.; Lambert, Stephen B.; Booy, Robert; Reynolds, Graham; Sebastian, Shite; Pride, Michael W.; Jansen, Kathrin U.; Anderson, Annaliesa S.; Scully, Ingrid L.

doi:10.1097/inf.0000000000000745

Cited by 16 publications

(18 citation statements)

References 32 publications

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“…The population groups at most risk of being infected with GAS diseases included people with underlying medical conditions [ 10 , 17 , 27 , 59 , 60 , 61 , 62 ], children (0 to 15 years) [ 8 , 11 , 36 , 51 , 52 , 53 , 54 , 55 , 56 ] and the elderly [ 10 , 43 , 57 , 58 ]. Additionally, pregnant and postpartum women were also identified as groups at risk for GAS diseases [ 39 , 41 , 63 , 64 , 65 , 66 , 67 , 68 , 69 ].…”

Section: Resultsmentioning

confidence: 99%

“…This includes homelessness [ 10 , 28 , 62 , 70 , 71 , 72 , 73 ], household overcrowding [ 20 , 51 ], limited household resources (including the sharing of personal items) [ 15 , 71 ], and poor housing conditions, such as dampness, poor ventilation and house temperature [ 18 , 20 ]. Low socioeconomic status [ 9 , 20 , 30 ], environmental tobacco smoke exposure [ 53 , 120 ] and exposure to biting insects or skin injuries or diseases were also identified as risk factors [ 15 , 60 , 71 , 112 , 121 ]. Several studies noted seasonal variations in the prevalence of GAS diseases [ 8 , 52 , 53 , 57 ].…”

Section: Resultsmentioning

confidence: 99%

“…Low socioeconomic status [ 9 , 20 , 30 ], environmental tobacco smoke exposure [ 53 , 120 ] and exposure to biting insects or skin injuries or diseases were also identified as risk factors [ 15 , 60 , 71 , 112 , 121 ]. Several studies noted seasonal variations in the prevalence of GAS diseases [ 8 , 52 , 53 , 57 ].…”

Section: Resultsmentioning

confidence: 99%

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A Review of Streptococcus pyogenes: Public Health Risk Factors, Prevention and Control

2021

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Streptococcus pyogenes, (colloquially named “group A streptococcus” (GAS)), is a pathogen of public health significance, infecting 18.1 million people worldwide and resulting in 500,000 deaths each year. This review identified published articles on the risk factors and public health prevention and control strategies for mitigating GAS diseases. The pathogen causing GAS diseases is commonly transmitted via respiratory droplets, touching skin sores caused by GAS or through contact with contaminated material or equipment. Foodborne transmission is also possible, although there is need for further research to quantify this route of infection. It was found that GAS diseases are highly prevalent in developing countries, and among indigenous populations and low socioeconomic areas in developed countries. Children, the immunocompromised and the elderly are at the greatest risk of S. pyogenes infections and the associated sequelae, with transmission rates being higher in schools, kindergartens, hospitals and residential care homes. This was attributed to overcrowding and the higher level of social contact in these settings. Prevention and control measures should target the improvement of living conditions, and personal and hand hygiene. Adherence to infection prevention and control practices should be emphasized in high-risk settings. Resource distribution by governments, especially in developed countries, should also be considered.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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A Review of Streptococcus pyogenes: Public Health Risk Factors, Prevention and Control

2021

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“…In the IU group in both data sets, an S. pyogenes ASV had the highest relative abundance and was three to seven times higher than that in other CU groups; the average relative and absolute abundances of S. pyogenes were higher in ulcers that had not improved following azithromycin treatment compared to those that had improved. S. pyogenes is a Gram-positive bacterium primarily found as part of the normal nasopharyngeal flora in 2 to 21% of healthy children (24,25). In addition to causing pharyngitis, S. pyogenes can cause multiple skin infections, including impetigo, erysipelas, cellulitis, and rarely necrotizing fasciitis (26).…”

Section: Discussionmentioning

confidence: 99%

Streptococcus pyogenes Is Associated with Idiopathic Cutaneous Ulcers in Children on a Yaws-Endemic Island

Griesenauer

González-Beiras

Fortney

et al. 2021

mBio

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Exudative cutaneous ulcers (CU) in yaws-endemic areas are associated with Treponema pallidum subsp. pertenue (TP) and Haemophilus ducreyi (HD), but one-third of CU cases are idiopathic (IU). Using mass drug administration (MDA) of azithromycin, a yaws eradication campaign on Lihir Island in Papua New Guinea reduced but failed to eradicate yaws; IU rates remained constant throughout the campaign. To identify potential etiologies of IU, we obtained swabs of CU lesions (n = 279) and of the skin of asymptomatic controls (AC; n = 233) from the Lihir Island cohort and characterized their microbiomes using a metagenomics approach. CU bacterial communities were less diverse than those of the AC. Using real-time multiplex PCR with pathogen-specific primers, we separated CU specimens into HD-positive (HD+), TP+, HD+TP+, and IU groups. Each CU subgroup formed a distinct bacterial community, defined by the species detected and/or the relative abundances of species within each group. Streptococcus pyogenes was the most abundant organism in IU (22.65%) and was enriched in IU compared to other ulcer groups. Follow-up samples (n = 31) were obtained from nonhealed ulcers; the average relative abundance of S. pyogenes was 30.11% in not improved ulcers and 0.88% in improved ulcers, suggesting that S. pyogenes in the not improved ulcers may be azithromycin resistant. Catonella morbi was enriched in IU that lacked S. pyogenes. As some S. pyogenes and TP strains are macrolide resistant, penicillin may be the drug of choice for CU azithromycin treatment failures. Our study will aid in the design of diagnostic tests and selective therapies for CU. IMPORTANCE Cutaneous ulcers (CU) affect approximately 100,000 children in the tropics each year. While two-thirds of CU are caused by Treponema pallidum subspecies pertenue and Haemophilus ducreyi, the cause(s) of the remaining one-third is unknown. Given the failure of mass drug administration of azithromycin to eradicate CU, the World Health Organization recently proposed an integrated disease management strategy to control CU. Success of this strategy requires determining the unknown cause(s) of CU. By using 16S rRNA gene sequencing of swabs obtained from CU and the skin of asymptomatic children, we identified another possible cause of skin ulcers, Streptococcus pyogenes. Although S. pyogenes is known to cause impetigo and cellulitis, this is the first report implicating the organism as a causal agent of CU. Inclusion of S. pyogenes into the integrated disease management plan will improve diagnostic testing and treatment of this painful and debilitating disease of children and strengthen elimination efforts.

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“…These can contribute to protection by activating complement deposition via the classical pathway, by direct opsonization mediated via Fc receptors on phagocytes and by neutralization of virulence factors and adhesins. In humans, GAS exposure leads to induction of antibodies against both the M protein and non-M proteins [ 10 – 14 ], and we recently showed that the IgG1 and IgG3 subclasses dominate this response [ 15 ]. Regarding the role of T cells, there have been indications that they do participate in protective anti-GAS immunity.…”

Section: Introductionmentioning

confidence: 99%

Local Th17/IgA immunity correlate with protection against intranasal infection with Streptococcus pyogenes

Mortensen¹,

Christensen²,

Hansen³

et al. 2017

PLoS ONE

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Streptococcus pyogenes (group A streptococcus, GAS) is responsible for a wide array of infections. Respiratory transmission via droplets is the most common mode of transmission but it may also infect the host via other routes such as lesions in the skin. To advance the development of a future vaccine against GAS, it is therefore important to investigate how protective immunity is related to the route of vaccine administration. To explore this, we examined whether a parenterally administered anti-GAS vaccine could protect against an intranasal GAS infection or if this would require locally primed immunity. We foundd that a parenteral CAF01 adjuvanted GAS vaccine offered no protection against intranasal infection despite inducing strong systemic Th1/Th17/IgG immunity that efficiently protected against an intraperitoneal GAS infection. However, the same vaccine administered via the intranasal route was able to induce protection against repeated intranasal GAS infections in a murine challenge model. The lack of intranasal protection induced by the parenteral vaccine correlated with a reduced mucosal recall response at the site of infection. Taken together, our results demonstrate that locally primed immunity is important for the defense against intranasal infection with Streptococcus pyogenes.

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Group A Streptococcal Carriage and Seroepidemiology in Children up to 10 Years of Age in Australia

Abstract: Children are exposed to GAS and other BHS at a young age, which is important for determining the target age for vaccination to protect before the period of risk.

Cited by 16 publications

References 32 publications

A Review of Streptococcus pyogenes: Public Health Risk Factors, Prevention and Control

A Review of Streptococcus pyogenes: Public Health Risk Factors, Prevention and Control

Streptococcus pyogenes Is Associated with Idiopathic Cutaneous Ulcers in Children on a Yaws-Endemic Island

Local Th17/IgA immunity correlate with protection against intranasal infection with Streptococcus pyogenes

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