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Correlation of virulence genes to clinical manifestations and outcome in patients with Streptococcus dysgalactiae subspecies equisimilis bacteremia.

AbstractBACKGROUND/PURPOSE:
Streptococcus dysgalactiae subsp. equisimilis (SDSE) is increasingly recognized as a human pathogen responsible for invasive infection and streptococcal toxic shock syndrome (STSS). The pathogen possesses virulence genes that resemble those found in Streptococcus pyogenes (GAS). We analyzed the association between these specific toxic genes, clinical presentations, and outcome in patients with SDSE infections.
METHODS:
Patients (older than 18 years) with community-acquired invasive bacteremia caused by SDSE bacteremia who were undergoing treatment at China Medical University Hospital from June 2007 to December 2010 were included in this study. Multiplex polymerase chain reaction was performed to identify virulence genes of the SDSE isolates. Demographic data, clinical presentations, and outcome in patients with SDSE infections were reviewed and analyzed.
RESULTS:
Forty patients with 41 episodes of SDSE bacteremia were reviewed. The median age of the patients with SDSE infection was 69.7 years; 55% were female and 78% had underlying diseases. Malignancy (13, 33%) and diabetes mellitus (13, 33%) were the most common comorbidities. The 30-day mortality rate was 12%. Compared with the survivors, the non-survivors had a higher rate of diabetes mellitus (80% vs. 26%), liver cirrhosis (60% vs.11%), shock (60% vs.17%), STSS (60% vs. 8%), and a high Pittsburgh bacteremia score >4 (40% vs. 6%). Most isolates had scpA, ska, saga, and slo genes, whereas speC, speG, speH, speI, speK, smez, and ssa genes were not detected. speA gene was identified only in one patient with STSS (1/6, 17%). All isolates were susceptible to penicillin, cefotaxime, levofloxacin, moxifloxacin, vancomycin, and linezolid.
CONCLUSION:
In invasive SDSE infections, most isolates carry putative virulence genes, such as scpA, ska, saga, and slo. Clinical SDSE isolates in Taiwan remain susceptible to penicillin cefotaxime, and levofloxacin.
AuthorsChia-Ta Tsai, Chih-Yu Chi, Cheng-Mao Ho, Po-Chang Lin, Chia-Hui Chou, Jen-Hsien Wang, Jui-Hsing Wang, Hsiao-Chuan Lin, Ni Tien, Kuo-Hsi Lin, Mao-Wang Ho, Jang-Jih Lu
JournalJournal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi (J Microbiol Immunol Infect) Vol. 47 Issue 6 Pg. 462-8 (Dec 2014) ISSN: 1995-9133 [Electronic] England
PMID24210866 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
CopyrightCopyright © 2013. Published by Elsevier B.V.
Chemical References
  • Anti-Bacterial Agents
  • DNA, Bacterial
  • Virulence Factors
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents (pharmacology)
  • Bacteremia (microbiology, pathology)
  • China
  • Community-Acquired Infections (microbiology, pathology)
  • DNA, Bacterial (genetics)
  • Female
  • Hospitals, University
  • Humans
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Polymerase Chain Reaction
  • Retrospective Studies
  • Streptococcal Infections (microbiology, pathology)
  • Streptococcus (drug effects, genetics, isolation & purification)
  • Taiwan
  • Treatment Outcome
  • Virulence Factors (genetics)

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