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Invasive infections due to a fish pathogen, Streptococcus iniae. S. iniae Study Group

M R Weinstein¹, M Litt, D A Kertesz

¹Department of Medicine, University of Toronto, ON, Canada.

The New England Journal of Medicine

|August 28, 1997

Summary

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Streptococcus iniae can cause invasive infections in humans who handle contaminated fish, particularly tilapia. A specific clone of this fish pathogen was identified, linked to human infections acquired through skin injuries.

Area of Science:

Microbiology
Aquatic Animal Health
Zoonotic Diseases

Background:

Streptococcus iniae is a significant fish pathogen responsible for disease outbreaks in aquaculture.
Human infections with S. iniae have been linked to handling fresh fish, with a notable cluster in Toronto.

Purpose of the Study:

To investigate human cases of invasive Streptococcus iniae infection.
To identify the source and genetic characteristics of S. iniae isolates from human and fish samples.

Main Methods:

Conducted prospective and retrospective community-based surveillance for human S. iniae infections.
Collected and analyzed S. iniae isolates from fish surfaces and infected tilapia brains.
Utilized pulsed-field gel electrophoresis (PFGE) for isolate characterization.

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Main Results:

Identified nine human cases of invasive S. iniae infection (cellulitis and endocarditis) linked to fish handling.
Eight patients reported percutaneous injuries; six infections were associated with tilapia.
PFGE analysis revealed indistinguishable isolates from human patients and related isolates from fish, including a common clone.

Conclusions:

Streptococcus iniae can cause invasive human infections following skin exposure during fish handling.
A specific clone of S. iniae capable of causing invasive disease in both fish and humans was identified.