Klinická a mikrobiologická charakteristika závažných infekcií spôsobených streptokokmi skupiny A

Czech version

Authors: H. ✝hupková ¹; M. Záborská ¹; V. Šišovský ²; P. Babál ²; M. Šimaljaková ³; M. Koreň ⁴; R. Reis ⁵; J. Kozáková ⁶; D. Bičan ¹
Authors‘ workplace: Mikrobiologický ústav LF UK a UNB, Bratislava ¹; Ústav patologickej anatómie, LF UK a UNB Bratislava Úrad pre dohľad nad zdravotnou starostlivosťou Bratislava ²; Dermatovenerologická klinika LF UK a UNB Bratislava ³; I. interná klinika LF UK a UNB Bratislava ⁴; II. chirurgická klinika LF UK a UNB Bratislava ⁵; Národné referenčné laboratórium pre streptokokové nákazy SZU Praha ⁶
Published in: Epidemiol. Mikrobiol. Imunol. 63, 2014, č. 3, s. 164-167
Category: Review articles, original papers, case report

Overview

Aim of the study:
Data analysis of the occurrence of severe infections caused by A-group of streptococci, emm typing of the isolated strains, and survey of resistance to the selected antibiotics.

Material and methods:
During the years 2012 and 2013, forty-three S. pyogenes strains were isolated from severe infections. The S. pyogenes strains were most frequently isolated from wounds and abscesses (36 patients), followed by isolations from haemocultures (5 patients), sputum (1 patient), autopsy samples (1 patient). The antimicrobial susceptibility to the selected antibiotics (penicillin, erythromycin, clindamycin, spiramycin, tetracycline) was detected by the disk-diffuse method, and the minimal inhibitory concentrations (MICs) were measured as well.

Results:
During the years 2012 and 2013, an increase of occurrence of severe streptococcal infections was detected: 27 and 16 cases, respectively. Resistance to macrolides was detected in 18, 5 % and 12, 5 %, to tetracyclines in 25, 9 % and 20 %, respectively. The emm type 1 was the most frequently detected in the isolated S. pyogenes strains. The risk factors for streptococcal infection development were followed up; injury was the most frequently detected – in 7 and 2 patients, respectively. The patients were most frequently treated by betalactam antibiotics (penicillin, ampicillin). In the year 2012, two cases were lethal.

Conclusion:
This study describes the cases of invasive Group A Streptococcal (GAS) infection as seen in hospital clinical practice. We detected an increased occurrence of S. pyogenes in the hospital; an increased resistance to erythromycin and tetracycline was detected as well. It is necessary to monitor the trends of antimicrobial resistance and the occurrence of emm types of isolated strains. Cooperation of the laboratory and clinical settings in the prevention and the therapy of streptococcal infections, first of all of the invasive ones, is important for the risk decrease of their occurrence.

Keywords:
Streptococcus pyogenes – závažné infekcie – rizikové faktory – emm typ

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