NEKOMOTO TS, MANEA SJ, KANENAKA RY, BURR RK, EFFLER PV; Interscience Conference on Antimicrobial Agents and Chemotherapy.
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 1999 Sep 26-29; 39: 657 (abstract no. 307).
State of Hawaii Dept. of Health, Honolulu, HI
BACKGROUND: The rate of group A Streptococcal (GAS) hospital admissions on Kauai increased from 20 to 80 per 100,000 population between 1994 and 1997. In 1997, the Hawaii Department of Health (HDOH) characterized circulating GAS isolates to determine whether severe clinical illness was associated with unique or commonly prevalent clones.METHODS: Surveillance of laboratories and hospitals was conducted from January 1 to December 31, 1997. A point-prevalence pharyngeal survey of 600 students at three geographically representative elementary schools was conducted on December 9. GAS isolates obtained from hospitalized case patients and asymptomatic school children were characterized by pulsed-field gel electrophoresis (PFGE), emm typing, and Streptococcal pyrogenic exotoxin (SPE) testing.RESULTS:54 hospitalized cases were identified, of which 38 (70%) were male. The mean age was 42 years. 43 (80%) presented with severe cellulitis, 6 (11%) with necrotizing fasciitis, and 5 (9%) with GAS sepsis. There was one death. PFGE of the 22 (41%) available case isolates revealed nine distinct patterns. Three patterns, P1 (emm 11, n=9); P2 (emm PT4245, n=5); and P3 (emm 56, n=2) were produced by 16 (72%) of the 22 isolates. The remaining six case isolates produced unique patterns P4 through P9. GAS isolates were recovered from 91(15%) of 600 surveyed school-children. Eight (9%) of these isolates produced pattern P1, P2, P4 or P5. All isolates were positive for SPE B; negative for SPEs A and C.CONCLUSIONS: Several GAS clones accounted for a disproportionate share of case infections; these clones were prevalent among asymptomatic school children and did not produce SPE A, a virulence factor previously associated with clusters of invasive illness. Further work is needed to ident ify risk factors for severe infection and the role of asymptomatic GAS carriers during community-wide outbreaks.
Publication Types:
Keywords:
- Bacterial Proteins
- Carrier State
- Child
- Electrophoresis, Gel, Pulsed-Field
- Exotoxins
- Fasciitis, Necrotizing
- Hawaii
- Humans
- Male
- Pharynx
- Streptococcus
- Streptococcus pyogenes
- Students
- Virulence Factors
- erythrogenic toxin
Other ID:
UI: 102246289
From Meeting Abstracts