Population-Based Study of Invasive Disease Due to β-Hemolytic Streptococci of Groups Other than A and B
Identifieur interne : 006454 ( Main/Exploration ); précédent : 006453; suivant : 006455Population-Based Study of Invasive Disease Due to β-Hemolytic Streptococci of Groups Other than A and B
Auteurs : Laura N. Broyles [Géorgie (pays), États-Unis] ; Chris Van Beneden [Géorgie (pays)] ; Bernard Beall [Géorgie (pays)] ; Richard Facklam [Géorgie (pays)] ; P. Lynn Shewmaker [Géorgie (pays)] ; Paul Malpiedi [Géorgie (pays)] ; Pamala Daily ; Arthur Reingold [États-Unis] ; Monica M. Farley [Géorgie (pays)]Source :
- Clinical Infectious Diseases [ 1058-4838 ] ; 2009-03-15.
Abstract
Background.β-Hemolytic streptococci of groups other than A and B (NABS) are increasingly recognized as causes of clinically significant disease, but precise information about this heterogeneous group is lacking. We report the incidence of NABS infection and describe the epidemiologic and clinical characteristics. Methods.Active, population-based surveillance for invasive NABS was performed over a 2-year period in the 8-county metropolitan Atlanta, Georgia, area and the 3-county San Francisco Bay, California, area. Clinical records were reviewed, and available isolates were sent to the Centers for Disease Control and Prevention (Atlanta) for additional microbiologic characterization. Incidences were calculated using year-appropriate US Census Bureau data. Results.A total of 489 cases of invasive NABS infection were identified (3.2 cases per 100,000 population). The median age of patients was 55 years; 64% of patients were males, and 87% had underlying diseases. The incidence was higher among black persons than white persons (4.0 vs. 2.5 cases per 100,000 population; P<.01) and increased with age among all races. Infections were community acquired in 416 cases (85%). Among the 450 patients (94%) with NABS infection who were hospitalized, 55 (12%) died. Of 266 isolates (54%) speciated at the Centers for Disease Control and Prevention, 212 (80%) were Streptococcus dysgalactiae subspecies equisimilis; 46 (17%) were members of the Streptococcus anginosus group. S. dysgalactiae subspecies equisimilis primarily presented as skin and soft-tissue infection in older patients, whereas individuals with invasive S. anginosus group infections were more likely to be younger patients with intra-abdominal infections. Conclusions.NABS comprise multiple distinct species that cause a significant number of community-acquired invasive infections. Clinical manifestations differ by species. Thus, speciation of invasive NABS may be warranted in clinical settings.
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DOI: 10.1086/597035
Affiliations:
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Lynn Shewmaker</name></author><author><name sortKey="Malpiedi, Paul" sort="Malpiedi, Paul" uniqKey="Malpiedi P" first="Paul" last="Malpiedi">Paul Malpiedi</name></author><author><name sortKey="Daily, Pamala" sort="Daily, Pamala" uniqKey="Daily P" first="Pamala" last="Daily">Pamala Daily</name></author><author><name sortKey="Reingold, Arthur" sort="Reingold, Arthur" uniqKey="Reingold A" first="Arthur" last="Reingold">Arthur Reingold</name></author><author><name sortKey="Farley, Monica M" sort="Farley, Monica M" uniqKey="Farley M" first="Monica M." last="Farley">Monica M. 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Broyles</name><affiliation wicri:level="1"><country xml:lang="fr">Géorgie (pays)</country><wicri:regionArea>Division of Infectious Diseases, Emory University School of Medicine, Atlanta</wicri:regionArea><wicri:noRegion>Atlanta</wicri:noRegion></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author><author><name sortKey="Van Beneden, Chris" sort="Van Beneden, Chris" uniqKey="Van Beneden C" first="Chris" last="Van Beneden">Chris Van Beneden</name><affiliation wicri:level="1"><country xml:lang="fr">Géorgie (pays)</country><wicri:regionArea>Respiratory Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta</wicri:regionArea><wicri:noRegion>Atlanta</wicri:noRegion></affiliation></author><author><name sortKey="Beall, Bernard" sort="Beall, Bernard" uniqKey="Beall B" first="Bernard" last="Beall">Bernard Beall</name><affiliation wicri:level="1"><country xml:lang="fr">Géorgie (pays)</country><wicri:regionArea>Respiratory Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta</wicri:regionArea><wicri:noRegion>Atlanta</wicri:noRegion></affiliation></author><author><name sortKey="Facklam, Richard" sort="Facklam, Richard" uniqKey="Facklam R" first="Richard" last="Facklam">Richard Facklam</name><affiliation wicri:level="1"><country xml:lang="fr">Géorgie (pays)</country><wicri:regionArea>Respiratory Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta</wicri:regionArea><wicri:noRegion>Atlanta</wicri:noRegion></affiliation></author><author><name sortKey="Shewmaker, P Lynn" sort="Shewmaker, P Lynn" uniqKey="Shewmaker P" first="P. Lynn" last="Shewmaker">P. Lynn Shewmaker</name><affiliation wicri:level="1"><country xml:lang="fr">Géorgie (pays)</country><wicri:regionArea>Respiratory Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta</wicri:regionArea><wicri:noRegion>Atlanta</wicri:noRegion></affiliation></author><author><name sortKey="Malpiedi, Paul" sort="Malpiedi, Paul" uniqKey="Malpiedi P" first="Paul" last="Malpiedi">Paul Malpiedi</name><affiliation wicri:level="1"><country xml:lang="fr">Géorgie (pays)</country><wicri:regionArea>Atlanta Veterans Affairs Medical Center, Atlanta</wicri:regionArea><wicri:noRegion>Atlanta</wicri:noRegion></affiliation></author><author><name sortKey="Daily, Pamala" sort="Daily, Pamala" uniqKey="Daily P" first="Pamala" last="Daily">Pamala Daily</name><affiliation><wicri:noCountry code="subField">Oakland</wicri:noCountry></affiliation></author><author><name sortKey="Reingold, Arthur" sort="Reingold, Arthur" uniqKey="Reingold A" first="Arthur" last="Reingold">Arthur Reingold</name><affiliation></affiliation><affiliation wicri:level="3"><country>États-Unis</country><placeName><settlement type="city">Berkeley (Californie)</settlement><region type="state">Californie</region></placeName><wicri:orgArea>University of California at Berkeley School of Public Health</wicri:orgArea></affiliation></author><author><name sortKey="Farley, Monica M" sort="Farley, Monica M" uniqKey="Farley M" first="Monica M." last="Farley">Monica M. Farley</name><affiliation wicri:level="1"><country xml:lang="fr">Géorgie (pays)</country><wicri:regionArea>Division of Infectious Diseases, Emory University School of Medicine, Atlanta</wicri:regionArea><wicri:noRegion>Atlanta</wicri:noRegion></affiliation><affiliation wicri:level="1"><country xml:lang="fr">Géorgie (pays)</country><wicri:regionArea>Atlanta Veterans Affairs Medical Center, Atlanta</wicri:regionArea><wicri:noRegion>Atlanta</wicri:noRegion></affiliation></author></analytic><monogr></monogr><series><title level="j">Clinical Infectious Diseases</title><title level="j" type="abbrev">Clinical Infectious Diseases</title><idno type="ISSN">1058-4838</idno><idno type="eISSN">1537-6591</idno><imprint><publisher>The University of Chicago Press</publisher><date type="published" when="2009-03-15">2009-03-15</date><biblScope unit="volume">48</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="706">706</biblScope><biblScope unit="page" to="712">712</biblScope></imprint><idno type="ISSN">1058-4838</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1058-4838</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract">Background.β-Hemolytic streptococci of groups other than A and B (NABS) are increasingly recognized as causes of clinically significant disease, but precise information about this heterogeneous group is lacking. We report the incidence of NABS infection and describe the epidemiologic and clinical characteristics. Methods.Active, population-based surveillance for invasive NABS was performed over a 2-year period in the 8-county metropolitan Atlanta, Georgia, area and the 3-county San Francisco Bay, California, area. Clinical records were reviewed, and available isolates were sent to the Centers for Disease Control and Prevention (Atlanta) for additional microbiologic characterization. Incidences were calculated using year-appropriate US Census Bureau data. Results.A total of 489 cases of invasive NABS infection were identified (3.2 cases per 100,000 population). The median age of patients was 55 years; 64% of patients were males, and 87% had underlying diseases. The incidence was higher among black persons than white persons (4.0 vs. 2.5 cases per 100,000 population; P<.01) and increased with age among all races. Infections were community acquired in 416 cases (85%). Among the 450 patients (94%) with NABS infection who were hospitalized, 55 (12%) died. Of 266 isolates (54%) speciated at the Centers for Disease Control and Prevention, 212 (80%) were Streptococcus dysgalactiae subspecies equisimilis; 46 (17%) were members of the Streptococcus anginosus group. S. dysgalactiae subspecies equisimilis primarily presented as skin and soft-tissue infection in older patients, whereas individuals with invasive S. anginosus group infections were more likely to be younger patients with intra-abdominal infections. Conclusions.NABS comprise multiple distinct species that cause a significant number of community-acquired invasive infections. Clinical manifestations differ by species. Thus, speciation of invasive NABS may be warranted in clinical settings.</div></front></TEI><affiliations><list><country><li>Géorgie (pays)</li><li>États-Unis</li></country><region><li>Californie</li></region><settlement><li>Berkeley (Californie)</li></settlement></list><tree><noCountry><name sortKey="Daily, Pamala" sort="Daily, Pamala" uniqKey="Daily P" first="Pamala" last="Daily">Pamala Daily</name></noCountry><country name="Géorgie (pays)"><noRegion><name sortKey="Broyles, Laura N" sort="Broyles, Laura N" uniqKey="Broyles L" first="Laura N." last="Broyles">Laura N. Broyles</name></noRegion><name sortKey="Beall, Bernard" sort="Beall, Bernard" uniqKey="Beall B" first="Bernard" last="Beall">Bernard Beall</name><name sortKey="Facklam, Richard" sort="Facklam, Richard" uniqKey="Facklam R" first="Richard" last="Facklam">Richard Facklam</name><name sortKey="Farley, Monica M" sort="Farley, Monica M" uniqKey="Farley M" first="Monica M." last="Farley">Monica M. Farley</name><name sortKey="Farley, Monica M" sort="Farley, Monica M" uniqKey="Farley M" first="Monica M." last="Farley">Monica M. Farley</name><name sortKey="Malpiedi, Paul" sort="Malpiedi, Paul" uniqKey="Malpiedi P" first="Paul" last="Malpiedi">Paul Malpiedi</name><name sortKey="Shewmaker, P Lynn" sort="Shewmaker, P Lynn" uniqKey="Shewmaker P" first="P. Lynn" last="Shewmaker">P. Lynn Shewmaker</name><name sortKey="Van Beneden, Chris" sort="Van Beneden, Chris" uniqKey="Van Beneden C" first="Chris" last="Van Beneden">Chris Van Beneden</name></country><country name="États-Unis"><noRegion><name sortKey="Broyles, Laura N" sort="Broyles, Laura N" uniqKey="Broyles L" first="Laura N." last="Broyles">Laura N. Broyles</name></noRegion><name sortKey="Reingold, Arthur" sort="Reingold, Arthur" uniqKey="Reingold A" first="Arthur" last="Reingold">Arthur Reingold</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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