Open AccessEpidemiology and distribution of 10 superantigens among invasive Streptococcus pyogenes disease in Germany from 2009 to 2014
Author(s) -
Matthias Imöhl,
Christina Fitzner,
Stephanie Perniciaro,
Mark van der Linden
Publication year - 2017
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0180757
Subject(s) - superantigen , streptococcus pyogenes , microbiology and biotechnology , fasciitis , biology , synovial fluid , sepsis , toxic shock syndrome , medicine , immunology , bacteria , pathology , genetics , t cell , surgery , staphylococcus aureus , immune system , alternative medicine , osteoarthritis
A nationwide laboratory-based surveillance study of invasive S . pyogenes infections was conducted in Germany. Invasive isolates (n = 719) were obtained between 2009 and 2014. Most isolates were obtained from blood (92.1%). The proportions of isolates from cerebrospinal fluid, pleural fluid, synovial fluid and peritoneal fluid were 3.9%, 1.8%, 1.7% and 0.6%, respectively. The most common emm types were emm 1 (31.8%), emm 28 (15.4%) and emm 89 (14.5%). The most common superantigen genes ( spe A, spe C, spe G, spe H, spe I, spe J, spe K, spe L, spe M, ssa ) identified from S . pyogenes were spe G (92.1%), spe J (50.9%), and spe C (42.0%). Significant associations of superantigen genes with underlying conditions or risks were observed in spe G, spe H, spe J, and spe K. Significant associations between emm types or superantigen genes with clinical complications were observed in emm type 3 and in superantigen gene spe A 1–3. Most frequent clinical manifestations included sepsis 59.4%, STSS 6.3%, meningitis 5.4%, and necrotizing fasciitis 5.0% (significantly associated with emm1 ).