Τίτλος:
Differences in the epidemiology between paediatric and adult invasive Streptococcus pyogenes infections
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
In order to investigate for possible differences between paediatric and adult invasive Streptococcus pyogenes (iGAS) infections, a total of 142 cases were identified in 17 Greek hospitals during 2003-2007, of which 96 were children and 46 adults. Bacteraemia, soft tissue infections, streptococcal toxic shock syndrome (STSS), and necrotizing fasciitis were the main clinical presentations (67·6%, 45·1%, 13·4%, and 12·0% of cases, respectively). Bacteraemia and lymphadenitis were significantly more frequent in children (P=0·019 and 0·021, respectively), whereas STSS was more frequent in adults (P=0·017). The main predisposing factors in children were varicella and streptococcal pharyngotonsillitis (25% and 19·8%, respectively), as opposed to malignancy, intravenous drug abuse and diabetes mellitus in adults (19·6%, 15·2% and 10·9%, respectively). Of the two dominant emm-types, 1 and 12 (28·2% and 8·5%, respectively), the proportion of emm-type 12 remained stable during the study period, whereas emm-type 1 rates fluctuated considerably. Strains of emm-type 1 from children were associated with erythromycin susceptibility, STSS and intensive-care-unit admission, whereas emm-type 12 isolates from adults were associated with erythromycin and clindamycin resistance. Finally, specific emm-types were detected exclusively in adults or in children. In conclusion, several clinical and epidemiological differences were detected, that could prove useful in designing age-focused strategies for prevention and treatment of iGAS infections. © 2013 Cambridge University Press.
Συγγραφείς:
Zachariadou, L.
Stathi, A.
Tassios, P.T.
Pangalis, A.
Legakis, N.J.
Papaparaskevas, J.
Avlamis, A.
Foustoukou, M.
Gizaris, V.
Iordanidou, M.
Kanellopoulou, M.
Kondyli, L.
Kouppari, G.
Levidiotou-Stefanou, S.
Malamou-Ladas, H.
Makri, A.
Paniara, O.
Perogambros, A.
Petroxeilou, V.
Vogiatzi, A.
Tsagaraki, A.
Περιοδικό:
Epidemiology and Infection
Εκδότης:
Cambridge University Press
Λέξεις-κλειδιά:
erythromycin; tetracycline; clindamycin; penicillin derivative; vancomycin, adult; antibiotic resistance; article; bacteremia; bacterial strain; bacterium isolate; chickenpox; child; diabetes mellitus; disease severity; group A streptococcal infection; human; infection sensitivity; intravenous drug abuse; lymphadenitis; major clinical study; necrotizing fasciitis; nonhuman; soft tissue infection; streptococcal pharyngitis; Streptococcus pyogenes; toxic shock syndrome; alcohol abuse; antibiotic sensitivity; Article; bacterium identification; comparative study; controlled study; disease predisposition; empyema; female; gene sequence; Greece; Greek (people); group A streptococcal infection; hospital admission; infant; intensive care unit; invasive Streptococcus pyogenes infection; male; meningitis; myositis; prospective study; streptococcal pharyngotonsillitis; streptococcal toxic shock syndrome; tonsillitis, Adolescent; Adult; Aged; Aged, 80 and over; Antigens, Bacterial; Bacterial Outer Membrane Proteins; Carrier Proteins; Child; Child, Preschool; Drug Resistance, Multiple, Bacterial; Female; Greece; Humans; Infant; Male; Middle Aged; Prospective Studies; Questionnaires; Risk Factors; Streptococcal Infections; Streptococcus pyogenes
DOI:
10.1017/S0950268813001386
