RESUMEN
Streptococcus pyogenes (group A Streptococcus, GAS) is a major human pathogen and causes every year over 600 millions upper respiratory tract onfections worldwide. Untreated or repeated infections may lead to post-infectional sequelae such as rheumatic heart disease, a major cause of GAS-mediated mortality. There is no comprehensive, longitudinal analysis of the M type distribution of upper respiratory tract strains isolated in Poland. Single reports describe rather their antibiotic resistance patterns or focus on the invasive isolates. Our goal was to analyse the clonal structure of the upper respiratory tract GAS isolated over multiple years in Poland. Our analysis revealed a clonal structure similar to the ones observed in high-income countries, with M1, M12, M89, M28, and M77 serotypes constituting over 80% of GAS strains. The M77 serotype is a major carrier of erythromycin resistance and is more often correlated with upper respiratory tract infections than other serotypes.
Asunto(s)
Infecciones del Sistema Respiratorio , Infecciones Estreptocócicas , Streptococcus pyogenes , Streptococcus pyogenes/patogenicidad , Streptococcus pyogenes/genética , Streptococcus pyogenes/aislamiento & purificación , Streptococcus pyogenes/efectos de los fármacos , Polonia/epidemiología , Humanos , Infecciones del Sistema Respiratorio/microbiología , Infecciones del Sistema Respiratorio/epidemiología , Infecciones Estreptocócicas/epidemiología , Infecciones Estreptocócicas/microbiología , Antibacterianos/farmacología , Serogrupo , Farmacorresistencia Bacteriana , Femenino , Masculino , Pruebas de Sensibilidad Microbiana , Eritromicina/uso terapéutico , Adulto , Niño , PreescolarRESUMEN
Animal bites represent a significant global health problem and account for approximately 1-2% of all visits to the emergency department. The vast majority of animal bite injuries are inflicted by dogs (80-90%,) and cats (5-15%). The most common complication following an animal bite is a wound infection, which tends to be polymicrobial and include both aerobic and anaerobic bacteria mainly of oropharyngeal origin. The likelihood of a cat bite becoming infected is double of that of a dog bite. Pasteurella spp. predominates in infected dog and cat bites. Dog bite injuries can be also associated with Capnocytophaga canimorsus, an aggressive organism which can cause disseminated infections (sepsis) and death, particularly in immunocompromised individuals. Early aggressive local wound cleansing is the most important therapy to prevent infection after animal bites. Due to the polymicrobial etiology of infected bite wounds, broad-spectrum antibiotics, covering both aerobic and anerobic bacteria, are often recommended as empiric treatment of animal bites.
Asunto(s)
Mordeduras y Picaduras/epidemiología , Mordeduras y Picaduras/microbiología , Gatos , Perros , Infección de Heridas/epidemiología , Animales , Antibacterianos/uso terapéutico , Mordeduras y Picaduras/diagnóstico , Capnocytophaga/aislamiento & purificación , Comorbilidad , Humanos , Pasteurella/aislamiento & purificación , Sepsis/tratamiento farmacológico , Sepsis/epidemiología , Infección de Heridas/tratamiento farmacológico , Infección de Heridas/microbiologíaRESUMEN
We describe a case of a life-threatening septicemia resulting from a previous dog bite wound. The isolated bacterium was Capnocytophaga canimorsus, a slow-growing Gram-negative bacillus commonly found in dog saliva. Known risk factors for invasive C. canimorsus infections are alcohol abuse, cigarette smoking, splenectomy or other forms of immunosuppression. Any clinician seeing patients with a history of a dog bite should consider this pathogen as a causative agent and take detailed history regarding exposure to animals.
Asunto(s)
Bacteriemia/microbiología , Mordeduras y Picaduras/complicaciones , Capnocytophaga/aislamiento & purificación , Infecciones por Bacterias Gramnegativas/microbiología , Adulto , Consumo de Bebidas Alcohólicas , Animales , Perros , Humanos , Masculino , FumarRESUMEN
Forty-one clinical isolates of group A streptococcus (GAS) were recovered in Poland from patients with severe invasive infections and were analyzed by phenotypic and genotypic techniques. All isolates were characterized by determining their susceptibilities to antimicrobial agents and by determining their types by pulsed-field gel electrophoresis, multilocus sequence typing, emm typing, and the detection of five streptococcal pyrogenic exotoxin genes (speA, speB, speC, speF, ssa). The isolates studied were fully susceptible to penicillin G, levofloxacin, quinupristin-dalfopristin, and linezolid. Resistance to tetracycline, chloramphenicol, and erythromycin was detected in 46.3, 12.1, and 9.8% of the isolates, respectively. A total of 23 different emm sequence types were identified, of which emm1 and emm12 (19.5% each) were the most common, followed by emm81, emm44/61, and emm85. All the emm1 isolates had the speA2 allele. Twenty-three unrelated sequence types (STs) were identified, with the most frequent STs, ST28 and ST36, corresponding to emm1 and emm12, respectively. Six newly found STs (STs 375, 376, 377, 378, 379, and 385) corresponded to emm types 74, 102, 77, 76, 84 and 63, respectively. The emm1 type and the presence of speA2 gene were associated with the severity of GAS infections. This work presents the first molecular study on Polish invasive GAS isolates.
Asunto(s)
Infecciones Estreptocócicas/microbiología , Streptococcus pyogenes/genética , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Electroforesis en Gel de Campo Pulsado , Femenino , Humanos , Lactante , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Análisis de Secuencia de ADN , Streptococcus pyogenes/clasificación , Streptococcus pyogenes/efectos de los fármacos , Virulencia/genéticaRESUMEN
OBJECTIVES: The aim of this study was to investigate Polish clinical isolates of Streptococcus pyogenes collected during a 7 year period using phenotypic and genotypic techniques. METHODS: A total of 816 isolates of S. pyogenes recovered from 33 medical centres in Poland were tested for their susceptibility to various antimicrobial agents. Erythromycin-resistant isolates were analysed by PFGE, multilocus sequence typing and emm typing methods. RESULTS: The tetracycline resistance rate was high (43%) among all S. pyogenes strains. Ninety-eight (12%) isolates were resistant to erythromycin. A low prevalence of the M phenotype (5.1%) associated with the presence of the mef(A) gene was found. All the isolates of the iMLSB phenotype harboured the erm(TR) gene. Out of the cMLSB isolates, 71.4% and 28.6% carried erm(TR) and erm(B), respectively. All isolates with erm(B) were resistant to telithromycin. PFGE analysis discerned 13 different patterns, A-N, with two predominant PFGE profiles--A (41 isolates) and B (25 isolates)--that in multilocus sequence typing corresponded, respectively, to a novel sequence type (ST) 367 and ST63. Overall, the representatives of these clones accounted for >90% of isolates of the iMLSB phenotype. CONCLUSIONS: A significant increase in erythromycin resistance was observed among clinical S. pyogenes collected in Poland over a 7 year period driven by the spread of two epidemic clones.