Molecular Characterization of Invasive Streptococcus dysgalactiae subsp. equisimilis, Japan.
Molecular Characterization of Invasive Streptococcus dysgalactiae subsp. equisimilis, Japan.
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DOI：
10.3201/eid2202.141732
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发表时间：
2016-02
影响因子：
11.8
通讯作者：
Ubukata K
中科院分区：
文献类型：
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作者：
Wajima T;Morozumi M;Hanada S;Sunaoshi K;Chiba N;Iwata S;Ubukata K
这种感染对老龄化人口的威胁越来越大。我们收集了2010年4月至2013年3月期间日本侵袭性链球菌感染患者的β-溶血性链球菌（1，611株分离株）。停乳链球菌最常见的是类马链球菌（SDSE）（n = 693）; 99%的SDSE感染患者为老年人（平均年龄75岁，SD ±15岁）。我们的目的是阐明SDSE分离株的分子和流行病学特征以及患者感染的特征。最常见的临床表现为无明确病灶的菌血症和蜂窝织炎，其他临床表现与沙门氏菌相似。化脓性感染临床表现也因患者年龄而异。SDSE分离株分为34个emm型; stG 6792最流行（27.1%），其次是stG 485和stG 245。死亡率没有根据emm类型的差异。多位点序列分型鉴定出46种序列类型和12种新类型。大环内酯类和喹诺酮类耐药基因分别占18.4%和2.6%，无β-内酰胺类耐药。在老龄化人群中，侵袭性SDSE感染的风险越来越大。
This infection is an increasing threat to aging populations. We collected β-hemolytic streptococci (1,611 isolates) from patients with invasive streptococcal infections in Japan during April 2010–March 2013. Streptococcus dysgalactiae subsp. equisimilis (SDSE) was most common (n = 693); 99% of patients with SDSE infections were elderly (mean age 75 years, SD ±15 years). We aimed to clarify molecular and epidemiologic characteristics of SDSE isolates and features of patient infections. Bacteremia with no identified focus of origin and cellulitis were the most prevalent manifestations; otherwise, clinical manifestations resembled those of S. pyogenes infections. Clinical manifestations also differed by patient’s age. SDSE isolates were classified into 34 emm types; stG6792 was most prevalent (27.1%), followed by stG485 and stG245. Mortality rates did not differ according to emm types. Multilocus sequence typing identified 46 sequence types and 12 novel types. Types possessing macrolide- and quinolone-resistance genes were 18.4% and 2.6%, respectively; none showed β-lactam resistance. Among aging populations, invasive SDSE infections are an increasing risk.