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PubMed1998

[Epidemiology of systemic Streptococcus pneumoniae infections].

OBJECTIVES: Invasive pneumococcal infections (bactereimia and meningitis) and pneumonia raise an authentic public health problem. We examined the epidemiology of these three different diseases. METHODS: For bacteremia and meningitis, data were collected from the National Public Health network in France. Incidence of pneumonia was calculated by applying ratios published in the literature to three different types of incidence data (bacteremia, pneumonia hospitalizations in Haute-Savoie and community acquired pneumonia in general practices). RESULTS: Annual incidence of meningitis was almost 1 per 100,000 inhabitants and 86 per 100,000 for bacteremia. Incidence was highest infants (< 5 years) and the elderly (> 65 years). All three of the calculation methods gave a convergent estimation of pneumonia cases with an average 132,000 cases per year, i.e., 220 per 100,000 inhibitants. This incidence was higher above 60 years of age. Death rate was unknown. Only 2.8% of the death certificates mentioned pneumonia. This give between 5,900 and 15,484 deaths, including 95% after the age of 60. CONCLUSION: Pneumococcal infections remain an authentic public health problem, both in terms of morbidity and mortality.

Aged↗
PubMedDate not supplied

Streptococcus milleri infection and pericardial abscess associated with esophageal carcinoma: report of two cases.

We report 2 cases of esophageal carcinoma with esophago-mediastinal fistula that developed pericardial abscess due to Streptococcus intermedius infection. Streptococcus intermedius, a generally harmless commensals in healthy humans, is not usually associated with infections of the oral cavity but may account for non-oral purulent infections. This report, however, highlights that Streptococcus intermedius infection can be life-threatening for some patients such as those with esophageal carcinoma with fistula.

Abscess↗
PubMed1983

Comparison of latex agglutination and counterimmunoelectrophoresis in the diagnosis of acute Streptococcus pneumoniae infections.

The ability of latex agglutination (Slidex Pneumokit) and counterimmunoelectrophoresis to detect Streptococcus pneumoniae antigen in body fluids was evaluated. The patients were classified as having proven Streptococcus pneumoniae infection, suspected Streptococcus pneumoniae infection, acute superinfection of chronic bronchitis or non-pneumococcal respiratory infection. Sixty-two non-pneumococcal meningitis patients were also included in the study. Latex agglutination and counterimmunoelectrophoresis tests were performed on serum, urine and cerebrospinal fluid specimens when indicated and repeated each week until the patient was discharged. Latex agglutination was done on samples boiled for 10 min. In vitro sensitivity of counterimmuno-electrophoresis and latex agglutination were 10 and 1 ng/ml respectively for type three antigen. In pulmonary disease (proven and suspected Streptococcus pneumoniae infection) counterimmunoelectrophoresis and latex agglutination had a clinical sensitivity of 72.9 and 87.5% respectively, a specificity of 96.3 and 92.6%, a predictive value for a positive test of 97.2 and 95.4% and for a negative test of 66.6 and 80.6%. Latex agglutination may offer an alternative to counterimmunoelectrophoresis in the rapid diagnosis of Streptococcus pneumoniae infections since it is easier to perform and gives a reliable result within 15 min.

Acute Disease↗
PubMed2005

Toward the development of an antidisease, transmission-blocking intranasal vaccine for group a streptococcus.

Infection with group A streptococcus (GAS) may result in a number of clinical conditions, including the potentially life-threatening postinfectious sequelae of rheumatic fever and rheumatic heart disease. As part of the search for a vaccine to prevent GAS infection, a conformationally constrained and minimally conserved peptide, J14, from the M protein of GAS has been defined. In the present study, J14 was formulated with bacterial outer membrane proteins (proteosomes) and then intranasally administered to outbred mice without additional adjuvant. Such immunization led to high titers of J14-specific serum immunoglobulin (Ig) G and mucosal IgA. After upper respiratory tract GAS challenge, immunized mice demonstrated increased survival and reduced GAS colonization of the throat.

Administration, Intranasal↗
PubMed1996

[An outbreak of Streptococcus pyogenes infections in institutions for the mentally retarded in Greater Copenhagen 1995].

The largest reported outbreak of infections due to Streptococcus pyogenes, M-type 18, in recent years is described. Ninety persons at institutions for mentally retarded (73% residents) had infections due to the epidemic strain. Pharyngitis and scarlatina were the most common infections. Six patients died, five having a streptococcal toxic shock syndrome. During the outbreak an intensive surveillance was carried out together with improved infection control measures and prompt culturing of residents and employees before antimicrobial treatment. The primary outbreak was confined but a secondary outbreak could not be prevented. This was probably due to difficulties in implementing proper isolation precautions in this setting.

Adult↗
PubMed1984

An outbreak of Streptococcus pyogenes infections in a nursing home.

An outbreak of serious infections caused by Streptococcus pyogenes occurred in a nursing home for elderly patients. The outbreak began in mid-winter and continued for 12 months. Thirteen residents and two nurses had infections. Severity of infection was worse in residents, who developed sepsis, necrotizing fasciitis, cellulitis, septic arthritis, pneumonia, and conjunctivitis; in contrast, the nurses had pharyngitis only. Six of thirteen residents required acute hospital care, and the index case died with sepsis. Typing of S. pyogenes was done in 13 of 15 cases, and the same serotype (M-non-typable, T-25) was found. Control measures consisted of identifying all patients with infections, obtaining cultures, and providing prompt treatment. Patients in nursing homes are highly susceptible to serious infections with S. pyogenes.

Aged↗
PubMed1988

Clinically significant Streptococcus anginosus (Streptococcus milleri) infections: a review of 186 cases.

We describe clinically significant infections due to Streptococcus anginosus in 186 patients; 114 (61.3%) males and 72 (38.7%) females, median age 42 years, range 9 months to 93 years. In 101 (54.3%) cases S anginosus alone caused infection and in 85 (45.7%) cases it was associated with other microorganisms. Abscesses accounted for 110 (59.1%) infections. Sites of infection were: miscellaneous skin and soft tissue, 64 (34.4%), intraabdominal 41 (22%), head and neck 34 (18.3%), pleuropulmonary 22 (11.8%), genitourinary 9 (4.8%), musculoskeletal 6 (3.2%), endocarditis 5 (2.7%) and primary bacteraemia 5 (2.7%). Treatment consisted of antibiotic therapy which was often prolonged, median 30 days, range 2-90 days, and surgery in 159 (85.5%). S anginosus infection was a contributory factor in two of the three deaths which occurred.

Abscess↗
PubMed2001

[Severe cutaneous Streptococcus pyogenes infections in the child: results of a multicenter survey].

UNLABELLED: To assess pediatric cases of severe cutaneous infections due to Streptococcus pyogenes. Since the beginning of 1980, the incidence of cellulitis and necrotizing fasciitis due to S. pyogenes has increased in adults. Serotyping of obtained isolates are in most cases M1, M3 or M5 protein. PATIENTS AND METHOD: A retrospective (1990-2000) survey was carried out in pediatric hospital centers. RESULTS: Three cases of necrotizing fasciitis and 15 of cellulitis were observed. In 30% of the cases, vancella lesions were associated; in the other cases, minor wounds were the site of the infection. Bacteriologic diagnosis was made by local samples in 14 cases; blood cultures were positive in four cases. In 11 cases, initial intravenous treatment consisted of third generation cephalosporin, in six cases of penicillin M or G and in one case of fusidic acid. In the second time, penicillin M was perfused in the majority of the cases. Mean duration of intravenous antibiotics perfusion was 15 days. There were no sequelae or death in this survey. CONCLUSIONS: Despite this study had limited epidemiological characteristics, it confirms that these two infections are rare. The frequency is probably underestimated, due to the difficulty in performing a diagnosis. The major site of infection was the varicella lesion. These two infections are so similar that it is frequent to mistake one infection for the other. Nonsteroidal anti-inflammatory drugs and site of infections did not influence prognosis. The treatment of cellulitis is penicillinotherapy whereas in necrotizing fasciitis early major surgery is often correlated with the rate of survival.

Cellulitis↗
PubMed1993

Investigation of milk-borne Streptococcus zooepidemicus infection associated with glomerulonephritis in Australia.

An outbreak of infection due to Streptococcus zooepidermicus is reported. The index case was a patient who suffered an episode of septicaemia complicated by glomerulonephritis. Two other persons in his family were found to be asymptomatic throat carriers. The source of the outbreak was unpasteurised milk from a house cow on the farm where the family lived. Molecular studies confirmed that the strains isolated from the index case, the other family members and the cow's milk were identical. Although a renal biopsy was not performed, the diagnostic criteria for poststreptococcal glomerulonephritis were satisfied. The organism is an uncommon human pathogen that sometimes causes outbreaks of severe infection which may be associated with glomerulonephritis.

Animals↗
PubMed2006

Therapeutic failures of antibiotics used to treat macrolide-susceptible Streptococcus pyogenes infections may be due to biofilm formation.

Streptococcus pyogenes infections often fail to respond to antibiotic therapy, leading to persistent throat carriage and recurrent infections. Such failures cannot always be explained by the occurrence of antibiotic resistance determinants, and it has been suggested that S. pyogenes may enter epithelial cells to escape antibiotic treatment. We investigated 289 S. pyogenes strains isolated from different clinical sources to evaluate their ability to form biofilm as an alternative method to escape antibiotic treatment and host defenses. Up to 90% of S. pyogenes isolates, from both invasive and noninvasive infections, were able to form biofilm. Specific emm types, such as emm6, appeared to be more likely to produce biofilm, although variations within strains belonging to the same type might suggest biofilm formation to be a trait of individual strains rather than a general attribute of a serotype. Interestingly, erythromycin-susceptible isolates formed a significantly thicker biofilm than resistant isolates (P < 0.05). Among resistant strains, those carrying the erm class determinants formed a less organized biofilm than the mef(A)-positive strains. Also, prtF1 appeared to be negatively associated with the ability to form biofilm (P < 0.01). Preliminary data on a selection of strains indicated that biofilm-forming isolates entered epithelial cells with significantly lower efficiency than biofilm-negative strains. We suggest that prtF1-negative macrolide-susceptible or mef(A)-carrying isolates, which are poorly equipped to enter cells, may use biofilm to escape antimicrobial treatments and survive within the host. In this view, biofilm formation by S. pyogenes could be responsible for unexplained treatment failures and recurrences due to susceptible microorganisms.

Adhesins, Bacterial↗