Increasing severity of invasive group a streptococcal disease in Australia: Clinical and molecular epidemiological features and identification of a new virulent m-nontypeable clone

Jonathan Carapetis, Roy Robins-Browne, Diana Martin, Tania Shelby-James, Geoffrey Hogg

Research output: Contribution to journalArticlepeer-review

84 Citations (Scopus)

Abstract

We conducted a 12-year review of all cases of group A streptococcal (GAS) bacteremia that were seen at Royal Children's Hospital in Melbourne, Australia, from 1982 through 1993. Forty-two cases were identified. There was a trend towards increased incidence of infections, as well as a clear increase in their severity, during the study period; more previously healthy children were affected during the last 6 years of the study (80% of cases) than during the first 6 years (47% of cases), and more complications occurred during the latter period than during the former (40% vs. 20%, respectively, with an 88% complication rate over the last 12 months). Seventy-four GAS isolates (41 invasive, 23 noninvasive, and 10 indeterminate) were analyzed. An M type 1 clone that was positive for the pyrogenic exotoxin A gene (speA) and that has been found to cause invasive disease in the Northern Hemisphere was most frequent among invasive isolates. Molecular typing also identified a genetically distinct strain that was virulent, mucoid, and M nontypable. Invasive GAS disease in Melbourne has become increasingly aggressive. Newer typing methods should be used in conjunction with traditional serotyping in order to maintain epidemiological surveillance of virulent strains.

Original languageEnglish
Pages (from-to)1220-1227
Number of pages8
JournalClinical Infectious Diseases
Volume21
Issue number5
DOIs
Publication statusPublished - Nov 1995
Externally publishedYes

Bibliographical note

Funding Information:
Received 8 March 1995; revised 30 May 1995. Financial support: The laboratory work was supported in part by a grant from the Howard Hughes Medical Institute. J. C. is supported by a scholarship from the Public Health Research and Development Committee of the National Health and Medical Research Council of Australia. Reprints or correspondence: Dr. Jonathan Carapetis, Menzies School of Health Research, P. 0. Box 41096, Casuarina, NT, 0811, Australia.

Copyright:
Copyright 2016 Elsevier B.V., All rights reserved.

Fingerprint

Dive into the research topics of 'Increasing severity of invasive group a streptococcal disease in Australia: Clinical and molecular epidemiological features and identification of a new virulent m-nontypeable clone'. Together they form a unique fingerprint.

Cite this