Toxic shock-like syndrome caused by group G Streptococcus

Kugi, Mari; Tojo, Hideaki; Haraga, Isao; Takata, Tohru; Handa, Kouichi; Tanaka, Koko

doi:10.1016/s0163-4453(98)92510-5

Cited by 26 publications

(23 citation statements)

References 6 publications

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“…), the causative bacteria in six cases were identified as S. dysgalactiae subsp. equisimilis (2,27,38) and S. equisimilis (24,45), which was renamed as S. dysgalactiae subsp. equisimilis according to the latest classification (47,48), while other reports did not identify the species of the causative bacteria.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, case reports referring to STSS caused by the Lancefield group C streptococci (GCS and G i and GGS, respectively) have also accumulated (1,2,11,14,17,24,27,30,35,38,45,49; H. Watanabe (ed. ), Rep. 24th Hyg.…”

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confidence: 99%

“…), Rep. 24th Hyg. Microbe Meet., p. [23][24][25][26][27]2002 [In Japanese]). However, epidemiological analysis and study for toxin production profiles of the causative organisms have not been fully conducted yet, whereas such analysis and study have been carried out for those organisms associated with GAS-induced STSS.…”

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confidence: 99%

“…Some of these bacteria cause various infections in domestic animals and, sometimes, in humans. Previous studies have demonstrated that none of these beta-hemolytic GCS and GGS secrete any major exotoxins (17,27,35,38,45,49). Unlike GAS-induced STSS, underlying conditions have been noted in most patients with STSS related to GCS and GGS.…”

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confidence: 99%

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Characterization of Group C and G Streptococcal Strains That Cause Streptococcal Toxic Shock Syndrome

Hashikawa

Iinuma

Furushita³

et al. 2004

J Clin Microbiol

165

119

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Twelve strains (the largest number ever reported) of group C and G 1 streptococci (GCS and GGS, respectively) that caused streptococcal toxic shock syndrome (STSS) were collected and characterized. Eleven strains were identified as Streptococcus dysgalactiae subsp. equisimilis, and one strain was identified as Streptococcus equi subsp. zooepidemicus. We found that it was the first reported case of STSS caused by S. equi subsp. zooepidemicus. Cluster analysis according to the 16S rRNA gene (rDNA) sequences revealed that the S. dysgalactiae strains belonged to clusters I and II, both of which were closely related. The emm types and the restriction patterns of chromosomal DNA measured by pulsed-field gel electrophoresis were highly variable in these strains except BL2719 and N1434. The 16S rDNA sequences and other characteristics of these two strains were indistinguishable, suggesting the clonal dissemination of this particular S. dysgalactiae strain in Japan. As the involvement of superantigens in the pathogenesis of group A streptococcus-related STSS has been suggested, we tried to detect known streptococcal superantigens in GCS and GGS strains. However, only the spegg gene was detected in seven S. dysgalactiae strains, with none of the other superantigen genes being detected in any of the strains. However, the sagA gene was detected in all of the strains except Tokyo1291. In the present study no apparent factor(s) responsible for the pathogenesis of STSS was identified, although close genetic relationships of GCS and GGS strains involved in this disease were suggested.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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Characterization of Group C and G Streptococcal Strains That Cause Streptococcal Toxic Shock Syndrome

Hashikawa

Iinuma

Furushita³

et al. 2004

J Clin Microbiol

165

119

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“…equisimilis strains having group A antigen rather than group C or G antigen have also been reported (Bert & Lambert-Zechovsky, 1997;Brandt et al, 1999;Katsukawa et al, 2002). Many recent studies have reported that this organism causes invasive and systemic streptococcal infections like GAS (Natoli et al, 1996;Wagner et al, 1996; Hirose et al, 1997; Kugi et al, 1998;Barnham et al, 2002;Cohen-Poradosu et al, 2004;Hashikawa et al, 2004). The organism has also been reported to cause a wide variety of human infections such as pharyngitis, cellulitis, sepsis, meningitis and endocarditis (Woo et al, 2001).…”

Section: Introductionmentioning

confidence: 97%

Molecular emm genotyping and antibiotic susceptibility of Streptococcus dysgalactiae subsp. equisimilis isolated from invasive and non-invasive infections

Sunaoshi

Murayama

Adachi

et al. 2010

Journal of Medical Microbiology

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To analyse the characteristics of infections caused by Streptococcus dysgalactiae subsp. equisimilis, clinical isolates (n5145) were collected at 11 medical institutions between September 2003 and October 2005. These isolates belonged to Lancefield group A (n55), group C (n518) or group G (n5122). Among all isolates, 42 strains were isolated from sterile samples such as blood, synovial fluid and tissue specimens from patients who were mostly over 50 years with invasive infections, and included seven cases of streptococcal toxic shock syndrome and necrotizing fasciitis. In contrast, the remaining 103 were isolated mainly from patients of all age groups with non-invasive infections such as pharyngotonsillitis. These isolates were classified into 25 types based on emm genotyping. A significant difference in emm types was observed between isolates from invasive and non-invasive infections (P,0.001): stG485, stG6792 and stG2078 predominated among isolates from invasive infections. A phylogenetic tree of complete open reading frames of emm genes in this organism showed high homology with those of Streptococcus pyogenes, but not with those of other streptococci. The presence of five different clones was estimated based on DNA profiles of isolates from invasive infections obtained by PFGE. Genes for resistance to macrolides [erm(A), three isolates; erm(B), five isolates; mef(A), seven isolates] and levofloxacin (mutations in gyrA and parC, four isolates) were identified in this organism. These results suggest the need for further nationwide surveillance of invasive infections caused by S. dysgalactiae subsp. equisimilis. INTRODUCTIONMost b-haemolytic streptococcal pathogens isolated from humans are identified as Streptococcus pyogenes (group A streptococci; GAS), Streptococcus agalactiae (group B streptococci; GBS), Streptococcus dysgalactiae subsp. equisimilis and species of the anginosus group that belong to Lancefield groups A, B, C, G or F (Facklam, 2002;Ruoff et al., 2003). In contrast to GAS and GBS, which are known to cause serious and systemic invasive infections, streptococci with Lancefield group C or G antigens were long considered to be commensal organisms that only rarely caused invasive infections as opportunistic pathogens.In 1996, S. dysgalactiae subsp. equisimilis was proposed as a new streptococcal taxon (Vandamme et al., 1996). Although rare, S. dysgalactiae subsp. equisimilis strains having group A antigen rather than group C or G antigen have also been reported (Bert & Lambert-Zechovsky, 1997;Brandt et al., 1999;Katsukawa et al., 2002 Notably, S. dysgalactiae subsp. equisimilis possesses many virulence factors shared with GAS, such as M protein (Fischetti, 1989; Schnitzler et al., 1995), streptolysin O (Gerlach et al., 1993Okumura et al., 1994), streptolysin S (Humar et al., 2002 and streptokinase (Walter et al., 1989;Ikebe et al., 2004). It has been suggested that these factors were transmitted from GAS to this species (Kalia et al., 2001).In the present report, we have described S. dysgalactiae ...

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Genotypic characterization of toxigenic group C and G streptococci isolated in Chennai, South India

Prabu

Menon

2011

Folia Microbiol

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Background & objectives: Increasing resistance to erythromycin has been observed worldwide in group C and group G streptococci (GCS/GGS). The information available from India is scanty. The aim of the study was to identify erythromycin resistant GCS/GGS isolates in Chennai, south India, and to compare erythromycin resistant genotypes with emm types. Methods: One hundred and thirty one GCS/GGS isolates were tested for erythromycin resistance by disc diffusion and agar dilution methods. Erythromycin resistance genotypes [ erm (A), erm (B) and mef (A)] were determined by a multiplex PCR. emm types of erythromycin resistant GCS/GGS isolates was also assessed using emm gene sequencing method. Results: Sixteen of the 131 isolates (12.21%) were resistant to erythromycin. Majority of the isolates were GGS (15/16). Eight of the 16 (50%) were S. dysgalactiae subsps. equisimilis . Twelve isolates (75%) were MLS B phenotype and four (25%) were M phenotype. Of the 12 isolates which exhibited MLS B resistance, seven showed cMLS B phenotype and were positive for erm (B) gene. The remaining five were iMLS B phenotype of which three were positive for erm (A) gene and two for erm (B) gene. erm (A) was common among carriers whereas erm (B) was common among clinical isolates. Interpretation & conclusions: MLS B was the predominant phenotype and erm (B) was the common genotype in the present study. The emm type stC1400.0 was frequently associated with erythromycin resistant GCS/GGS in our study.

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Toxic shock-like syndrome caused by group G Streptococcus

Cited by 26 publications

References 6 publications

Characterization of Group C and G Streptococcal Strains That Cause Streptococcal Toxic Shock Syndrome

Characterization of Group C and G Streptococcal Strains That Cause Streptococcal Toxic Shock Syndrome

Molecular emm genotyping and antibiotic susceptibility of Streptococcus dysgalactiae subsp. equisimilis isolated from invasive and non-invasive infections

Genotypic characterization of toxigenic group C and G streptococci isolated in Chennai, South India

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