Streptococcal toxic shock syndrome caused by Streptococcus suis serotype 2.
Streptococcal toxic shock syndrome caused by Streptococcus suis serotype 2.
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DOI：
10.1371/journal.pmed.0030151
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发表时间：
2006-05
期刊：
影响因子：
15.8
通讯作者：
Gao GF
中科院分区：
文献类型：
--
作者：
Tang J;Wang C;Feng Y;Yang W;Song H;Chen Z;Yu H;Pan X;Zhou X;Wang H;Wu B;Wang H;Zhao H;Lin Y;Yue J;Wu Z;He X;Gao F;Khan AH;Wang J;Zhao GP;Wang Y;Wang X;Chen Z;Gao GF
猪链球菌2型(S.suis sertype 2，SS2)是一种主要的人畜共患病病原体，仅在人类中引起零星的脑膜炎和败血症。大多数(如果不是全部)链球菌中毒性休克综合征(STSS)病例迄今已被很好地记录下来，都与非SS2 A组链球菌(GAS)有关。然而，最近在四川省大规模爆发的SS2中国似乎是由侵袭性更强的深部组织感染STSS引起的，其特征是急性高热、血管塌陷、低血压、休克和多器官衰竭。我们通过临床观察和实验室实验对2005年7月至8月在人和猪中爆发的SS2感染进行了调查。人类患者的临床和病理特征揭示了典型的STSS的特征，到目前为止，这种特征只与气体感染有关。我们回顾发现，这次疫情与1998年江苏省中国的一次疫情非常相似。我们从最近暴发的人和猪的标本中分离和分析了37株细菌和8株猪的细菌，以及我们在实验室保存的1998年暴发的3株人和2株猪的分离株。采用光镜观察、猪感染实验、多重聚合酶链式反应、限制性片段长度多态(RFLP)和多重序列比对等方法对分离株进行鉴定。多条证据证实，高毒力的SS2毒株是这两起疫情的病原体。据我们所知，我们第一次报告了由SS2引起的两起STSS疫情，SS2是一种非气体链球菌。2005年的暴发与204例有记录的人间病例中的38例死亡有关；1998年的暴发与25例报告的人间病例中的14例死亡有关。大多数死亡病例以性传播感染为特征；其中一些是脑膜炎或严重败血症。这些人类STSS在人类中暴发的分子机制仍然不清楚，也是进一步研究的目标。2005年中国猪链球菌暴发的临床描述，影响了200多人，并对受影响的猪和人的致病菌株进行了初步鉴定。
Streptococcus suis serotype 2 ( S. suis 2, SS2) is a major zoonotic pathogen that causes only sporadic cases of meningitis and sepsis in humans. Most if not all cases of Streptococcal toxic shock syndrome (STSS) that have been well-documented to date were associated with the non-SS2 group A streptococcus (GAS). However, a recent large-scale outbreak of SS2 in Sichuan Province, China, appeared to be caused by more invasive deep-tissue infection with STSS, characterized by acute high fever, vascular collapse, hypotension, shock, and multiple organ failure. We investigated this outbreak of SS2 infections in both human and pigs, which took place from July to August, 2005, through clinical observation and laboratory experiments. Clinical and pathological characterization of the human patients revealed the hallmarks of typical STSS, which to date had only been associated with GAS infection. Retrospectively, we found that this outbreak was very similar to an earlier outbreak in Jiangsu Province, China, in 1998. We isolated and analyzed 37 bacterial strains from human specimens and eight from pig specimens of the recent outbreak, as well as three human isolates and two pig isolates from the 1998 outbreak we had kept in our laboratory. The bacterial isolates were examined using light microscopy observation, pig infection experiments, multiplex-PCR assay, as well as restriction fragment length polymorphisms (RFLP) and multiple sequence alignment analyses. Multiple lines of evidence confirmed that highly virulent strains of SS2 were the causative agents of both outbreaks. We report, to our knowledge for the first time, two outbreaks of STSS caused by SS2, a non-GAS streptococcus. The 2005 outbreak was associated with 38 deaths out of 204 documented human cases; the 1998 outbreak with 14 deaths out of 25 reported human cases. Most of the fatal cases were characterized by STSS; some of them by meningitis or severe septicemia. The molecular mechanisms underlying these human STSS outbreaks in human beings remain unclear and an objective for further study. Clinical description of a 2005 S. suis outbreak in China that affected over 200 individuals and initial characterization of the pathogenic isolates from affected pigs and humans.
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