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Invasive streptococci

R C Spencer1

  • 1Department of Microbiology, Bristol Royal Infirmary, UK.

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
|January 1, 1995
PubMed
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Streptococcus pyogenes infections, once thought eliminated by penicillin, resurged in the 1980s causing severe invasive disease and toxic shock syndrome. These outbreaks highlight the need for continued vigilance against this resilient pathogen.

Area of Science:

  • Microbiology and Infectious Diseases
  • Bacteriology
  • Epidemiology

Background:

  • Streptococcus pyogenes (Group A Streptococcus) historically caused severe infections and sequelae like rheumatic fever.
  • Penicillin was believed to have virtually eliminated Streptococcus pyogenes as a significant pathogen.
  • The mid-1980s saw focal resurgences of rheumatic fever and increased reports of invasive streptococcal disease.

Purpose of the Study:

  • To document the resurgence of Streptococcus pyogenes infections.
  • To describe the clinical syndromes associated with these resurgent infections.
  • To identify specific serotypes involved in the outbreaks.

Main Methods:

  • Review of reported cases of rheumatic fever and invasive streptococcal disease.

Related Experiment Videos

  • Isolation and serotyping of Streptococcus pyogenes strains from affected communities.
  • Clinical description of two distinct syndromes: invasive streptococcal infection and streptococcal toxic shock syndrome.

    • Main Results:

    • Increased incidence of rheumatic fever linked to specific serotypes (M-1, 3, 5, 6, 18) producing mucoid colonies.
    • Emergence of invasive streptococcal infections in healthy individuals, often with deep-seated infections and sepsis.
    • Description of streptococcal toxic shock syndrome, frequently associated with serotype M-1, characterized by cutaneous focus, rapid multi-organ failure, and high fatality rates (approaching 50%).

    Conclusions:

    • Streptococcus pyogenes has re-emerged as a significant pathogen, challenging its prior perceived elimination.
    • Specific serotypes, particularly M-1, are associated with severe invasive disease and toxic shock syndrome.
    • The resurgences underscore the need for ongoing surveillance and understanding of Streptococcus pyogenes epidemiology and pathogenicity.