- 作者：Esther Tamayo ; Milagrosa Montes ; Jos茅 Mar铆a Garc铆a-Arenzana ; Emilio P茅rez-Trallero
- 关键词：Group A streptococcus infection ; emm-Type ; emm-Subtype ; T-type ; MLST ; Vaccine ; Pharyngitis ; Otitis
- 刊名：Journal of Infection
- 出版年：January, 2014
- 年：2014
- 卷：68
- 期：1
- 页码：50-57
- 全文大小：557 K
Summary
Objective
To know the clinical entities caused by Streptococcus pyogenes as well as the characteristics of the isolates involved in them throughout a 7-year-study.Methods
All S. pyogenes infectious episodes from the community recorded in the reference hospital of Gipuzkoa between 2005 and 2011 were included (n聽=聽11,342). A random selection of 10% of total isolates was characterized by emm-type, T-type and multilocus-sequence-type.
Results
Main clinical presentations were: pharyngitis (n聽=聽9467), otitis (n聽=聽797), dermal infections (n聽=聽506), and genital infections (n聽=聽374). Highest frequency of pharyngitis and otitis was detected in children aged 2-8 years old and 1-year old, respectively. Among 29 emm-types, 8 (emm4, emm89, emm3, emm87, emm1, emm12, emm6 and emm75) grouped >70% of isolates. emm4 was significantly associated with 0-4 year-old patients, and emm89 and emm77 with patients >64 years; by infection type, emm4, emm87 and emm12 were associated with pharyngitis, emm1 and emm6 with otitis, emm89 with dermal infections, and emm77 with genital infections.
Conclusions
Predominant emm-type changed every year, although the diversity was similar throughout the study period. S. pyogenes pharyngitis maximum incidence presented at earlier age than expected. emm-type associations with age and specific clinical presentations were influenced by population immunity and strain tropism.