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[Invasive streptococcal (group A) infection of soft tissues in a Moscow surgical hospital]

N I Briko, E V Glushkova, N F Dmitrieva

    Vestnik Rossiiskoi Akademii Meditsinskikh Nauk
    |December 18, 2013
    PubMed
    Abstract

    Insights

    Invasive streptococcal soft tissue infections were linked to specific emm-types and lower immune responses. Risk factors like trauma and diabetes worsened outcomes in surgical patients.

    Area of Science:

    • Infectious Diseases
    • Immunology
    • Microbiology

    Background:

    • Soft tissue infections caused by Group A Streptococcus (GAS) can lead to severe invasive disease.
    • Understanding the specific bacterial strains and host immune responses is crucial for managing these infections.
    • Identifying patient risk factors can aid in early detection and prevention of severe GAS infections.

    Purpose of the Study:

    • To characterize the emm-types of Streptococcus prevalent in invasive soft tissue infections.
    • To assess the human immune response to streptococcal antigens, specifically streptolysin-O and group A carbohydrate.
    • To identify patient conditions that increase the risk and severity of invasive streptococcal soft tissue infections.

    Main Methods:

    • A cohort of 101 surgical patients with confirmed GAS soft tissue infections was studied.
    • emm-typing was performed by sequencing the emm gene and comparing it to the CDC database.
    • Anti-streptolysin-O (ASO) and anti-group A carbohydrate IgM levels were measured using photometry and ELISA.

    Main Results:

    • emm28 and emm64 were exclusively found in invasive infections among 34 identified emm-types.
    • The most frequent emm-types identified were 1, 49, 60, 66, 77, 84, and 88.
    • Invasive GAS infection patients showed a high prevalence of negative (65%) or low-positive (26%) ASO titers.

    Conclusions:

    • Reduced humoral immune response, alongside risk factors like trauma, alcoholism, diabetes, and chronic venous insufficiency, contributes to severe GAS infections.
    • Specific emm-types were identified as predominant in invasive soft tissue GAS infections in the studied surgical unit population.
    • These findings highlight the importance of immune status and pre-existing conditions in the pathogenesis of invasive streptococcal infections.

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