A Genetic-Based Evaluation of the Principal Tissue Reservoir for Group A Streptococci Isolated from Normally Sterile Sites

The primary sites of infection and principal reservoirs for transmission of group A streptococci are the nasopharyngeal mucosa and the impetigo lesion. However, pharyngitis and impetigo are rarely observed prior to invasive disease, and, thus, the origin of invasive strains is largely unknown. As pa...

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Bibliographic Details
Published in:The Journal of infectious diseases 1997-07, Vol.176 (1), p.177-182
Main Authors: Fiorentino, Therese R., Beall, Bernard, Mshar, Patricia, Bessen, Debra E.
Format: Article
Language:English
Subjects:
Bacterial diseases
Base Sequence
Biological and medical sciences
Chromosomes, Bacterial
Disease reservoirs
DNA
Emerging diseases
Epidemiology
Genes
Genetic Markers
Human bacterial diseases
Humans
Impetigo
Impetigo - microbiology
Infections
Infectious diseases
Lesions
Major Articles
Medical sciences
Molecular Sequence Data
Nasopharyngeal diseases
Nasopharynx - microbiology
Polymerase chain reaction
Staphylococcal infections, streptococcal infections, pneumococcal infections
Streptococcus pyogenes - genetics
Streptococcus pyogenes - isolation & purification
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Summary:The primary sites of infection and principal reservoirs for transmission of group A streptococci are the nasopharyngeal mucosa and the impetigo lesion. However, pharyngitis and impetigo are rarely observed prior to invasive disease, and, thus, the origin of invasive strains is largely unknown. As part of an active surveillance program, group A streptococci were obtained from normally sterile tissue sites of Connecticut residents during a 6-month period. Organisms were analyzed for genetic markers that distinguish between strains that use the nasopharynx versus an impetiginous lesion as their primary site for infection. The nasopharyngeal marker was observed for most sterile-site isolates, suggesting that the upper respiratory tract is the principal reservoir from which organisms causing invasive disease are disseminated. Genotypic analyses of sterile-site isolates support the view that additional factors, aside from a recent emergence of a few virulent clones, are important contributors to invasive group A streptococcal disease.
ISSN:0022-1899
1537-6613
DOI:10.1086/514020