Severe invasive group A streptococcal infections in Ontario, Canada: 1987-1991

B Demers; A E Simor; H Vellend; P M Schlievert; S Byrne; F Jamieson; S Walmsley; D E Low

doi:10.1093/clind/16.6.792

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Severe invasive group A streptococcal infections in Ontario, Canada: 1987-1991

Journal article

Peer reviewed

Severe invasive group A streptococcal infections in Ontario, Canada: 1987-1991

B Demers, A E Simor, H Vellend, P M Schlievert, S Byrne, F Jamieson, S Walmsley and D E Low

Clinical infectious diseases, Vol.16(6), pp.792-800

06/1993

DOI: 10.1093/clind/16.6.792

PMID: 8329511

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Abstract

During the past few years, there has been an apparent increase in serious infections due to group A streptococci (GAS) worldwide. We describe our experience with severe invasive GAS infections in Ontario, Canada, during the past 5 years (February 1987 through December 1991). A case was defined as the isolation of GAS from blood or normally sterile tissue in association with hypotension (systolic blood pressure, < 90 mm Hg). Fifty cases were identified in patients ranging in age from 4 to 100 years (median age, 47 years); 29 (58%) of the patients died. A primary focus of infection was identified in 38 cases (76%), with soft tissue being the site involved most frequently (68%). No focus of infection was found in 12 patients, and 36 patients (72%) were bacteremic. Complications included acute respiratory distress syndrome (21 of 50), acute renal failure (20 of 50), hypocalcemia (19 of 24), elevated creatinine kinase values (21 of 27), coagulation abnormalities (15 of 21), and hepatitis (15 of 24). Eleven cases (22%) were nosocomial; one of these was secondary to another nosocomial case. Thirty-three isolates were available for M and T typing and for determination of the presence of the genes for streptococcal pyrogenic exotoxin (SPE). The most frequent types were M1T1 (10) and M12/T12 (8). Twelve isolates possessed the speA gene, and 16 isolates had the speC gene. Only three isolates possessed both speA and speC. All isolates possessed the speB gene.

Polymerase Chain Reaction

Humans

Middle Aged

Cross Infection - mortality

Oligodeoxyribonucleotides - chemistry

Child, Preschool

Molecular Sequence Data

Male

Streptococcal Infections - mortality

Cross Infection - complications

Streptococcus pyogenes - genetics

Base Sequence

Aged, 80 and over

Adult

Female

Streptococcus pyogenes - classification

Child

Serotyping

Cross Infection - epidemiology

Shock, Septic - epidemiology

Shock, Septic - complications

Streptococcal Infections - epidemiology

Chi-Square Distribution

Shock, Septic - mortality

Adolescent

Exotoxins - genetics

Ontario - epidemiology

Aged

Streptococcal Infections - complications

Details

Title: Subtitle: Severe invasive group A streptococcal infections in Ontario, Canada: 1987-1991
Creators: B Demers - Department of Microbiology, Mount Sinai Hospital, Toronto, Ontario, Canada
A E Simor
H Vellend
P M Schlievert
S Byrne
F Jamieson
S Walmsley
D E Low
Resource Type: Journal article
Publication Details: Clinical infectious diseases, Vol.16(6), pp.792-800
Publisher: United States
DOI: 10.1093/clind/16.6.792
PMID: 8329511
ISSN: 1058-4838
eISSN: 1537-6591
Language: English
Date published: 06/1993
Academic Unit: Microbiology and Immunology; Internal Medicine
Record Identifier: 9984001109302771

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