ABSTRACT
A rapid PCR-enzyme-linked immunosorbent assay for identification of 10 important emm gene types of Streptococcus pyogenes was developed. The emm genotypes of a coded panel of strains of known M serotype were determined, and in 144 of 149 cases (97%) the results were congruous. Strains of types that were not included in the panel of capture probes were emm genotyped by sequencing.
Subject(s)
Antigens, Bacterial , Bacterial Outer Membrane Proteins , Bacterial Proteins/genetics , Carrier Proteins , Enzyme-Linked Immunosorbent Assay/methods , Polymerase Chain Reaction/methods , Sequence Analysis, DNA , Streptococcus pyogenes/classification , Biological Specimen Banks , Genotype , Molecular Sequence Data , Reference Standards , SerotypingSubject(s)
Fasciitis, Necrotizing/epidemiology , Streptococcal Infections/epidemiology , Streptococcus pyogenes , Adolescent , Adult , Aged , Aged, 80 and over , Bacteremia/epidemiology , Child , Child, Preschool , Cluster Analysis , England/epidemiology , Fasciitis, Necrotizing/microbiology , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Serotyping , Shock, Septic/epidemiology , Streptococcal Infections/microbiology , Streptococcus pyogenes/classification , Streptococcus pyogenes/isolation & purification , Streptococcus pyogenes/pathogenicity , Wales/epidemiologySubject(s)
Streptococcal Infections/epidemiology , Streptococcus pyogenes , Bacteremia/epidemiology , Bacteremia/etiology , Bacteremia/microbiology , England/epidemiology , Environmental Monitoring , Epidemiological Monitoring , Humans , Population Surveillance , Seroepidemiologic Studies , Serotyping , Streptococcal Infections/etiology , Streptococcal Infections/microbiology , Streptococcus pyogenes/classification , Streptococcus pyogenes/isolation & purification , Wales/epidemiologyABSTRACT
A total of 16,909 cultures of Streptococcus pyogenes (Lancefield group A) isolated in Britain during 1980-90 were examined for T- and M-protein antigens. One or other M antigen was detected in 92.6% of the strains. The numbers of isolates of some serotypes, such as M3 and M12, did not show great variation from year-to-year, whereas there were nationwide epidemics, extending over several years, caused by strains of serotypes M1 and M49. Isolates of serotypes M1 and M3 were associated particularly with invasive disease and fatal infections. Representatives of serotypes M80, M81 and the provisional types PT180, PT1658 and PT5757 were isolated most often from cases of pyoderma. Erythromycin resistance was detected in 30 serotypes but one half of all of the resistant isolates belonged to serotype M4.
Subject(s)
Streptococcal Infections/microbiology , Streptococcus pyogenes/classification , Bacteremia/microbiology , Cross Infection/epidemiology , Cross Infection/microbiology , Disease Outbreaks , Drug Resistance, Microbial , Erythromycin/pharmacology , Female , Glomerulonephritis/epidemiology , Glomerulonephritis/microbiology , Humans , Male , Meningitis, Bacterial/epidemiology , Meningitis, Bacterial/microbiology , Nasal Mucosa/microbiology , Occupational Diseases/epidemiology , Occupational Diseases/microbiology , Otitis Media/epidemiology , Otitis Media/microbiology , Pharyngitis/epidemiology , Pharyngitis/microbiology , Psoriasis/epidemiology , Psoriasis/microbiology , Puerperal Infection/epidemiology , Puerperal Infection/microbiology , Rheumatic Fever/epidemiology , Rheumatic Fever/microbiology , Scarlet Fever/epidemiology , Scarlet Fever/microbiology , Serotyping , Skin Diseases, Bacterial/epidemiology , Skin Diseases, Bacterial/microbiology , Streptococcal Infections/epidemiology , Streptococcus pyogenes/drug effects , Streptococcus pyogenes/pathogenicity , United Kingdom/epidemiology , Virulence , Vulvovaginitis/epidemiology , Vulvovaginitis/microbiologyABSTRACT
We report an outbreak of 23 neonatal group A streptococcal infections including two cases of septicaemia in a nursery for the newborn. At the same time, 19 mothers had puerperal endometritis. The outbreak lasted for about 2 months and could not be eradicated by ordinary hygienic measures. In a colonisation study, 19 of 90 umbilical stumps studied on the day of discharge from hospital harboured group A streptococci, all of the same epidemic strain T28 provisional M-type 2841/opacity factor positive (T28/MPT2841/OF+). Chlorhexidine gluconate was therefore applied daily to the umbilical stumps. The outbreak came to an end with the introduction of this procedure. The time interval between delivery and recognition of infection was shorter in infants than in mothers. There were also only two infected mother-infant pairs. Taken together, this suggests that infected umbilical stumps on symptomless infants were a likely source of the maternal infections. Throughout 1 year from the introduction of the chlorhexidine treatment, we have not seen a case of group A streptococcal infection in neonates. Surveillance cultures from umbilical cords after the outbreak have also been negative. We conclude that bacteriological surveillance of umbilical stumps is valuable in recognising an outbreak and should be seriously considered when a group A streptococcal infection has been recorded in a nursery.
