|
|
|
|
|
Volume 38, Number 2, April 2005
| | Clinical and genetic analysis of invasive and non-invasive group A streptococcal infections in central Taiwan |
Chia-Hui Kao1,2, Po-Yen Chen2, Fang-Liang Huang2, Chih-Wei Chen2, Ching-Shiang Chi, Yu-Hui Lin3, Chi-Yen Shih3, Bor-Shen Hu3, Chia-Ro Li3, Jui-Shan Ma4, Yeu-Jun Lau4, Kun-Chia Lu5, Hsiu-Wen Yu5
1Department of Pediatrics, Tungs' Taichung MetroHarbor Hospital, Taichung; 2Department of Pediatrics and 3Section of Infectious Diseases, Department of Medicine, Taichung Veterans General Hospital, Taichung; 4Section of Infectious Diseases, Show-Chwan Memorial Hospital, Changhua; and 5Department of Pediatrics, Chen Ching Hospital, Taiwan
Received: July 10, 2004 Revised: September 8, 2004 Accepted: October 18, 2004
Corresponding author: Dr. Po-Yen Chen, Department of Pediatrics, Taichung Veterans General Hospital, 160, Section 3, Chung-Kang Road, Taichung 407, Taiwan. E-mail:
This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
To evaluate the clinical, bacteriologic, and genetic relatedness between invasive and non-invasive infections caused by group A Streptococcus (GAS), we retrospectively analyzed the GAS isolates in our hospital from the past decade. A total of 70 GAS-infected cases were enrolled in our study from the period 1993 to 2002. Twenty one cases had invasive disease, and 49 were non-invasive. Their medical records were reviewed, and demographic data were collected for analysis. Antimicrobial susceptibility testing was conducted according to the National Committee for Clinical Laboratory Standards for Streptococcus spp. Isolates were subjected to chromosomal SmaI (Invitrogen) digestion of pulsed-field gel electrophoresis (PFGE), and emm typing was also performed. The mean age of the invasive group was 41.1 ± 22.4 years compared with 13.0 ± 16.6 years for the non-invasive group (p<0.05). Eighty one percent of the invasive group had underlying diseases. Diabetes and malignancy were the 2 most common medical conditions. All isolates were susceptible to penicillin. The resistance rate was 42.8% and 55.1% for erythromycin in the invasive and non-invasive groups, respectively. A total of 51 different PFGE types were identified among the GAS isolates without particular genotypes. Serotype M12 was the most common one (28.4%), followed by M4 (19.4%). Our study demonstrated that the patients in the invasive group were older, with more underlying diseases, and with a higher mortality rate. Antimicrobial susceptibility of the isolates was the same in both groups. There was no epidemic strain, nor did PFGE reveal a more invasive clone.
Key words: Bacterial drug resistance, group A Streptococcus, risk factors, serotyping, streptococcal M protein
J Microbiol Immunol Infect 2005;38:105-111.
| |
|
|
