Clinical and microbiologic characteristics of invasive Streptococcus pyogenes infections in north and south India.

2.50
Hdl Handle:
http://hdl.handle.net/10033/244332
Title:
Clinical and microbiologic characteristics of invasive Streptococcus pyogenes infections in north and south India.
Authors:
Haggar, Axana; Nerlich, Andreas; Kumar, Rajesh; Abraham, Vinod J; Brahmadathan, Kootallur N; Ray, Pallab; Dhanda, Vanita; Joshua, John Melbin Jose; Mehra, Narinder; Bergmann, Rene; Chhatwal, G Singh; Norrby-Teglund, Anna
Abstract:
The lack of epidemiologic data on invasive Streptococcus pyogenes infections in many developing countries is concerning, as S. pyogenes infections are commonly endemic in these areas. Here we present the results of the first prospective surveillance study of invasive Streptococcus pyogenes infections in India. Fifty-four patients with invasive S. pyogenes infections were prospectively enrolled at two study sites, one in the north and one in the south of India. Sterile-site isolates were collected, and clinical information was documented using a standardized questionnaire. Available acute-phase sera were tested for their ability to inhibit superantigens produced by the patient's own isolate using a cell-based neutralizing assay. The most common clinical presentations were bacteremia without focus (30%), pneumonia (28%), and cellulitis (17%). Only two cases of streptococcal toxic shock syndrome and no cases of necrotizing fasciitis were identified. Characterization of the isolates revealed great heterogeneity, with 32 different emm subtypes and 29 different superantigen gene profiles being represented among the 49 sterile-site isolates. Analyses of acute-phase sera showed that only 20% of the cases in the north cohort had superantigen-neutralizing activity in their sera, whereas 50% of the cases from the south site had neutralizing activity. The results demonstrate that there are important differences in both clinical presentation and strain characteristics between invasive S. pyogenes infections in India and invasive S. pyogenes infections in Western countries. The findings underscore the importance of epidemiologic studies on streptococcal infections in India and have direct implications for current vaccine developments.
Affiliation:
Center for Infectious Medicine, Karolinska Institutet, Stockholm, Sweden.
Citation:
Clinical and microbiologic characteristics of invasive Streptococcus pyogenes infections in north and south India. 2012, 50 (5):1626-31 J. Clin. Microbiol.
Journal:
Journal of clinical microbiology
Issue Date:
May-2012
URI:
http://hdl.handle.net/10033/244332
DOI:
10.1128/JCM.06697-11
PubMed ID:
22357508
Type:
Article
Language:
en
ISSN:
1098-660X
Appears in Collections:
Publications of Dept. Medizinische Mikrobiologie (MMIK)

Full metadata record

DC FieldValue Language
dc.contributor.authorHaggar, Axanaen_GB
dc.contributor.authorNerlich, Andreasen_GB
dc.contributor.authorKumar, Rajeshen_GB
dc.contributor.authorAbraham, Vinod Jen_GB
dc.contributor.authorBrahmadathan, Kootallur Nen_GB
dc.contributor.authorRay, Pallaben_GB
dc.contributor.authorDhanda, Vanitaen_GB
dc.contributor.authorJoshua, John Melbin Joseen_GB
dc.contributor.authorMehra, Narinderen_GB
dc.contributor.authorBergmann, Reneen_GB
dc.contributor.authorChhatwal, G Singhen_GB
dc.contributor.authorNorrby-Teglund, Annaen_GB
dc.date.accessioned2012-09-17T14:05:47Z-
dc.date.available2012-09-17T14:05:47Z-
dc.date.issued2012-05-
dc.identifier.citationClinical and microbiologic characteristics of invasive Streptococcus pyogenes infections in north and south India. 2012, 50 (5):1626-31 J. Clin. Microbiol.en_GB
dc.identifier.issn1098-660X-
dc.identifier.pmid22357508-
dc.identifier.doi10.1128/JCM.06697-11-
dc.identifier.urihttp://hdl.handle.net/10033/244332-
dc.description.abstractThe lack of epidemiologic data on invasive Streptococcus pyogenes infections in many developing countries is concerning, as S. pyogenes infections are commonly endemic in these areas. Here we present the results of the first prospective surveillance study of invasive Streptococcus pyogenes infections in India. Fifty-four patients with invasive S. pyogenes infections were prospectively enrolled at two study sites, one in the north and one in the south of India. Sterile-site isolates were collected, and clinical information was documented using a standardized questionnaire. Available acute-phase sera were tested for their ability to inhibit superantigens produced by the patient's own isolate using a cell-based neutralizing assay. The most common clinical presentations were bacteremia without focus (30%), pneumonia (28%), and cellulitis (17%). Only two cases of streptococcal toxic shock syndrome and no cases of necrotizing fasciitis were identified. Characterization of the isolates revealed great heterogeneity, with 32 different emm subtypes and 29 different superantigen gene profiles being represented among the 49 sterile-site isolates. Analyses of acute-phase sera showed that only 20% of the cases in the north cohort had superantigen-neutralizing activity in their sera, whereas 50% of the cases from the south site had neutralizing activity. The results demonstrate that there are important differences in both clinical presentation and strain characteristics between invasive S. pyogenes infections in India and invasive S. pyogenes infections in Western countries. The findings underscore the importance of epidemiologic studies on streptococcal infections in India and have direct implications for current vaccine developments.en_GB
dc.language.isoenen
dc.rightsArchived with thanks to Journal of clinical microbiologyen_GB
dc.subject.meshAdolescenten_GB
dc.subject.meshAdulten_GB
dc.subject.meshAgeden_GB
dc.subject.meshAged, 80 and overen_GB
dc.subject.meshAntibodies, Bacterialen_GB
dc.subject.meshAntibodies, Neutralizingen_GB
dc.subject.meshChilden_GB
dc.subject.meshChild, Preschoolen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshGenotypeen_GB
dc.subject.meshHumansen_GB
dc.subject.meshIndiaen_GB
dc.subject.meshInfanten_GB
dc.subject.meshInfant, Newbornen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshMolecular Epidemiologyen_GB
dc.subject.meshQuestionnairesen_GB
dc.subject.meshSerotypingen_GB
dc.subject.meshStreptococcal Infectionsen_GB
dc.subject.meshStreptococcus pyogenesen_GB
dc.subject.meshSuperantigensen_GB
dc.subject.meshYoung Adulten_GB
dc.titleClinical and microbiologic characteristics of invasive Streptococcus pyogenes infections in north and south India.en
dc.typeArticleen
dc.contributor.departmentCenter for Infectious Medicine, Karolinska Institutet, Stockholm, Sweden.en_GB
dc.identifier.journalJournal of clinical microbiologyen_GB

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