| 1. |
- Lamagni, Theresa L, et al.
(författare)
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Epidemiology of severe Streptococcus pyogenes disease in Europe.
- 2008
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Ingår i: Journal of Clinical Microbiology. - 1098-660X. ; 46:7, s. 2359-2367
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Tidskriftsartikel (refereegranskat)abstract
- The past two decades have brought worrying increases in severe Streptococcus pyogenes diseases globally. To investigate and compare the epidemiological patterns of these diseases within Europe, data on severe S. pyogenes infections were collected through an EU FP-5 funded programme (Strep-EURO). Prospective population-based surveillance of severe S. pyogenes infection diagnosed during 2003 and 2004 was undertaken in eleven countries across Europe (Cyprus, Czech Republic, Denmark, Finland, France, Germany, Greece, Italy, Romania, Sweden, UK) using a standardised case definition. A total of 5522 cases of severe S. pyogenes infection were identified across the eleven countries during this period. Rates of reported infection varied, reaching 3/100,000 population in the northern European countries. Seasonal patterns of infections showed remarkable congruence between countries. Risk of infection was highest among the elderly, with rates being higher in males than females in most countries. Skin lesions/wounds were the most common predisposing factor, reported in 25% of cases; 21% had no predisposing factors reported. Skin and soft tissue was the most common focus of infection, 32% of patients having cellulitis and 8% necrotizing fasciitis. The overall 7-day case fatality rate was 19%, 44% among cases who developed streptococcal toxic shock syndrome. Findings from Strep-EURO confirm a high incidence of severe S. pyogenes disease in Europe. Furthermore, these results have identified targets for public health intervention, as well as raising awareness of severe S. pyogenes disease across Europe.
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| 2. |
- Luca, Bogdan, et al.
(författare)
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Clinical and epidemiological aspects of invasive Streptococcus pyogenes infections in Denmark during 2003 and 2004
- 2008
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Ingår i: Journal of Clinical Microbiology. - 1098-660X. ; 46:1, s. 79-86
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Tidskriftsartikel (refereegranskat)abstract
- Active surveillance of invasive group A streptococcal (GAS) infections was conducted in Denmark during 2003 and 2004 as a part of the Strep-EURO initiative. The main objective was to improve understanding of the epidemiology of invasive GAS disease in Denmark. During the 2 years, 278 cases were reported, corresponding to a mean annual incidence of 2.6 cases per 100,000 inhabitants. The vast majority of isolates, 253 (91%), were from blood, with the remaining 25 (9%) being from cerebrospinal fluid, joints, or other normally sterile sites. The mean case fatality rate (CFR) was 20%, with the rate being higher in patients more than 70 years of age (36.5%). For streptococcal toxic shock syndrome (STSS) and necrotizing fasciitis the CFRs were 53% and 25%, respectively. Out of 16 T types recorded, three predominated: T28 (23%), T1 (22%), and the cluster T3/13/B3264 (14%). Among 29 different emm types, emm28 and emm1 accounted for 51% of strains, followed by emm3 (11%), emm89 (7%), and emm12 (5.5%). Low resistance rates were detected for macrolide-lincosamide-streptogramin B (MLSB) antibiotics (3%) and tetracycline (8%); two isolates exhibited coresistance to tetracycline and macrolides. Of nine pyrogenic exotoxin (superantigen) genes examined, speA and speC were identified in 58% and 40% of the strains, respectively; either of the genes was present in all strains causing STSS. Most strains harbored speG (99%). ssa was present in 14% of the isolates only. In Denmark, as in comparable countries, GAS invasive disease shows a sustained, high endemicity, with involvement of both established and emerging streptococcal emm and T types.
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| 3. |
- Luca, Bogdan, et al.
(författare)
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Molecular characterization of invasive and non-invasive Streptococcus pyogenes isolates from Romania.
- 2008
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Ingår i: Journal of Medical Microbiology. - : Microbiology Society. - 0022-2615 .- 1473-5644. ; 57:Pt 11, s. 1354-1363
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Tidskriftsartikel (refereegranskat)abstract
- In 2002, the Romanian National Reference Laboratory was invited to join the Strep-EURO project to study invasive Streptococcus pyogenes infections. During 2003 and 2004, a total of 33 isolates recovered from invasive disease were received from eight Romanian counties. For comparison, 102 isolates from non-invasive disease, as well as a collection of 12 old invasive strains (isolated between 1967 and 1980) were included. All isolates were characterized by several methods: T and emm typing, presence of the fibronectin-binding protein F1 gene (prtF1), serum opacity factor (sof), and superantigen (SAg) genes (speA, speB, speC, speF, speG, speH, ssa and smeZ). The recent invasive isolates exhibited 19 emm-types, of which emm1, emm81, emm76, emm49 and emm78 covered 57 % of the strains. Furthermore, multilocus sequence typing analysis revealed nine new sequence types, corresponding to emm types 1, 12, 49, 81, 92, 100, 106 and 119. The non-invasive isolates comprised 24 different emm types with a predominance of emm1 and 12; the old invasive strains were of eight emm types, of which four were unique for this group. All isolates harboured speB and speF; smeZ was detected in all invasive strains, except for the emm49 and emm81 isolates. The majority of isolates from carriers, and patients with pharyngitis were prtF1 positive, most of these (14 strains) being emm12. High tetracycline resistance rates were noted among both invasive and control isolates (54 % and 35 %, respectively), whereas macrolide resistance rates were low (3 % and 5 %, respectively). Active and continuing surveillance is required to provide an accurate assessment of the disease burden and to provide epidemiological data on the character of isolates in Romania.
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| 4. |
- Spindler, Carl, et al.
(författare)
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Effects of a large-scale introduction of the pneumococcal polysaccharide vaccine among elderly persons in Stockholm, Sweden
- 2008
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Ingår i: Vaccine. - : Elsevier BV. - 1873-2518 .- 0264-410X. ; 26:43, s. 5541-5546
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Tidskriftsartikel (refereegranskat)abstract
- In October 1998 Stockholm County launched a 3-year vaccination campaign with the 23-valent pneumococcal polysaccharide vaccine (PPV-23) directed towards all elderly persons. We analysed the impact of this campaign on the incidence and serotype distribution of invasive pneumococcal disease (IPD) in Stockholm County, where the vaccine coverage was 36%, as compared to Skane County, where no vaccination campaign was performed. The incidence of vaccine-type IPD in Stockholm declined significantly during the study period (1997-2001) in elderly persons, from 50 to 28.9/100,000, hot not in other age groups in Stockholm, nor in any age group in Skane. (C) 2008 Elsevier Ltd. All rights reserved.
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