Epidemiologic Analysis of Group A Streptococcal Serotypes Associated with Severe Systemic Infections, Rheumatic Fever, or Uncomplicated Pharyngitis

More than 1100 group A streptococcal isolates collected in the United States (1988–1990) were examined to document an association of individual serotypes with specific clinical infections during the recent resurgence of group A infections and their sequelae.The most commonly isolated strains from pa...

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Bibliographic Details
Published in:The Journal of infectious diseases 1992-08, Vol.166 (2), p.374-382
Main Authors: Johnson, Dwight R., Stevens, Dennis L., Kaplan, Edward L.
Format: Article
Language:English
Subjects:
Adult
Bacteremia - epidemiology
Bacteremia - microbiology
Bacterial diseases
Bacterial diseases of the respiratory system
Biological and medical sciences
Child
Epidemiology
Geographic regions
Geography
Glomerulonephritis
Human bacterial diseases
Humans
Infections
Infectious diseases
Major Articles
Medical sciences
Pharyngitis
Pharyngitis - epidemiology
Pharyngitis - microbiology
Prospective Studies
Rheumatic fever
Rheumatic Fever - epidemiology
Rheumatic Fever - microbiology
Serotyping
Shock, Septic - epidemiology
Shock, Septic - microbiology
Statistical significance
Streptococcal infections
Streptococcal Infections - epidemiology
Streptococcal Infections - microbiology
Streptococcus pyogenes
Streptococcus pyogenes - classification
Toxicity
United States - epidemiology
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Summary:More than 1100 group A streptococcal isolates collected in the United States (1988–1990) were examined to document an association of individual serotypes with specific clinical infections during the recent resurgence of group A infections and their sequelae.The most commonly isolated strains from patients with only uncomplicated streptococcal pharyngitis (“control” strains) wereM serotypes 1, 2, 4, and 12. M1, M3, and M18 were statistically significantlymore frequently isolated from patients with serious invasive infections and M3 and M18 from patients with rheumatic fever compared with the distribution of serotypes from the 866 control strains. An unexpected and important finding indicated that isolation rates of M1 streptococci varied geographicallywithin the United States by year. The propensity for M1 streptococci to be statistically associated with severe systemic infections appeared unrelated to the M1 isolation rates from patients with only uncomplicated pharyngitis, thus offering additional support for the concept of strain-associated virulence rather than virulence broadly related to a given serotype.
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/166.2.374