The epidemiology of severe Streptococcus pyogenes associated disease in Europe

Lamagni, Theresa; Efstratiou, A; Vuopio‐Varkila, Jaana; Jasir, Aftab; Schalén, Claës; Strep-EURO,

doi:10.2807/esm.10.09.00563-en

Cited by 108 publications

(116 citation statements)

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“…Although >95% of these cases and deaths occur in developing countries, few data exist about the epidemiology of these infections in developing countries. In addition, few data describe the clinical signs and symptoms, case-fatality rate, and risk factors associated with invasive GAS disease or the molecular epidemiology of invasive GAS disease in developing countries because most published reports originate from industrialized countries (4)(5)(6)(7)(8).…”

mentioning

confidence: 99%

Prospective Surveillance of Invasive Group A Streptococcal Disease, Fiji, 2005–2007

Steer¹,

Jenney²,

Kado³

et al. 2009

Emerg. Infect. Dis.

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mentioning

confidence: 99%

Prospective Surveillance of Invasive Group A Streptococcal Disease, Fiji, 2005–2007

Steer¹,

Jenney²,

Kado³

et al. 2009

Emerg. Infect. Dis.

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“…The epidemiology of severe GAS disease has been changing over the last 20 years: along with the classical suppurative and nonsuppurative forms, new manifestations such as necrotizing fasciitis and streptococcal toxic shock syndrome were described in the early 1990s, and the implementation of enhanced surveillance programs for invasive GAS infections was urged in many European countries (21).…”

mentioning

confidence: 99%

“…A further nationwide surveillance program for invasive GAS disease was undertaken for a period of 2 years (2003 to 2005) within the Strep-EURO project on severe GAS infection in Europe, funded by the Fifth Framework Program of the European Commission's Directorate-General for Research (21).…”

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confidence: 99%

emm Types, Virulence Factors, and Antibiotic Resistance of Invasive Streptococcus pyogenes Isolates from Italy: What Has Changed in 11 Years?

et al. 2007

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To investigate the epidemiology and characteristics of invasive group A streptococcal (GAS) disease over 11 years in Italy, this study compared the emm types and the superantigen toxin genes speA and speC as well as the erythromycin, clindamycin, and tetracycline susceptibilities of 207 invasive GAS strains collected during two national enhanced surveillance periods (1994 to 1996 and 2003 to 2005) and the time between each set of surveillance periods. The present study demonstrated that emm1 strains were consistently responsible for about 20% of invasive GAS infections, while variations in the frequencies of the other types were noted, although the causes of most cases of invasive infections were restricted to emm1, emm3, emm4, emm6, emm12, and emm18. During the 1994 to 1996 surveillance period, an emm89 epidemic clone spread across the northern part of Italy. A restricted macrolide resistance phenotype-type distribution of the bacteriophage-encoded speA toxin as well as of macrolide resistance genes was noted over time. Indeed, the recent acquisition of macrolide resistance in previously susceptible emm types was observed.

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“…The worrying increase in the prevalence of these severe infections and their high fatality rates emphasize the need for rapid diagnostic tests to aid in patient management (1,2).…”

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confidence: 99%

Reassessment of the Role of Rapid Antigen Detection Tests in Diagnosis of Invasive Group A Streptococcal Infections

et al. 2016

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i Rapid antigen detection tests (RADTs) for group A streptococci (GAS) are widely used for diagnosing acute pharyngitis, which has led to a considerable reduction in antibiotic prescriptions over the past decade. Beyond this intended use, their reassessment on invasive samples may be relevant in the management of life-threatening GAS infections. To this end, we evaluated the performances of three RADTs, culture, GAS PCR, and 16S rRNA gene PCR assays, and compared them with a composite gold standard (GAS-PCR assay and/or culture) for the diagnosis of severe GAS infection. A total of 192 specimens from deep-tissue (mostly normally sterile) sites enriched for 75 GAS-positive samples were enrolled in the study. The three evaluated RADTs showed sensitivities ranging from 88.0% to 94.7% versus 98.7% for GAS PCR, 84% for 16S rRNA gene PCR, and 77.3% for culture. The sensitivities of the ImmunoCard STAT! Strep A test (Meridian Bioscience) and the NADAL Strep A strip (Nal Von Minden) were similar to that of GAS PCR (P ‫؍‬ 0.25 and 0.03, respectively) and higher than that of culture (P ‫؍‬ 0.001 and 0.006, respectively), whereas the SD Bioline Strep A test strip (Standard Diagnostics) showed a performance similar to that of culture (P ‫؍‬ 0.02). The three RADTs detected 10 distinct emm types, including a predominance of emm 1 (33.3%), emm 89 (10.6%), and emm 12 (7.6%). No false-positive results were observed, leading to a specificity of 100% for all the evaluated RADTs. The GAS RADTs turned out to be sensitive, specific, and easy-to-use tools that may aid in the management of invasive GAS infections in 24/7 point-of-care laboratories by enabling early diagnosis and focused therapy. Group A streptococci (GAS) are common bacterial pathogens responsible for mild diseases, such as pharyngitis, and invasive and life-threatening infections resulting from their dissemination into deep tissues. The worrying increase in the prevalence of these severe infections and their high fatality rates emphasize the need for rapid diagnostic tests to aid in patient management (1, 2).Over the past 2 decades, manufacturers have developed immunochromatographic rapid antigen detection tests (RADTs) that detect the polysaccharide C cell-wall antigen of bacteria. These tests are now widely used for diagnosing pharyngitis in pediatric outpatient clinics and private practices, which has considerably reduced the number of antibiotic prescriptions and resulted in fewer throat cultures performed by laboratories (3-5).Extending their indication beyond this intended use, namely, on deep-seated samples, may reduce delays in the diagnosis of invasive infections. To this end, we evaluated the performances of three commercially available RADTs approved for pharyngitis in the diagnosis of invasive GAS infections and compared them with those of conventional culture and molecular techniques. MATERIALS AND METHODSPatients and clinical specimens. This survey was conducted by three teaching hospitals (in Lyon, Grenoble, and Saint-Etienne, France) between May 2013 a...

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The epidemiology of severe Streptococcus pyogenes associated disease in Europe

Cited by 108 publications

References 0 publications

Prospective Surveillance of Invasive Group A Streptococcal Disease, Fiji, 2005–2007

Prospective Surveillance of Invasive Group A Streptococcal Disease, Fiji, 2005–2007

emm Types, Virulence Factors, and Antibiotic Resistance of Invasive Streptococcus pyogenes Isolates from Italy: What Has Changed in 11 Years?

Reassessment of the Role of Rapid Antigen Detection Tests in Diagnosis of Invasive Group A Streptococcal Infections

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