Invasive group a streptococcal disease in Taiwan is not associated with the presence of streptococcal pyrogenic exotoxin genes

Po Ren Hsueh, Jiunn Jong Wu, Pei Jane Tsai, Jien Wei Liu, Yin Ching Chuang, Kwen Tay Luh

Research output: Contribution to journalArticlepeer-review

58 Citations (Scopus)

Abstract

We reviewed the clinical features of 44 patients with invasive group A streptococcal (GAS) disease who were treated at two teaching hospitals in southern Taiwan from 1991 to 1994. Genes encoding streptococcal pyrogenic exotoxin types A (speA), B (speB), C (speC), and F (speF) and serotypes of M1, M6, and M12 were determined by polymerase chain reaction to target specific sequences in the 44 isolates recovered from these patients and in 28 isolates recovered from upper respiratory sites in 28 additional patients during the study period. The protease activity of these isolates was tested by using the casein plate method. Of the 44 patients with invasive diseases, 25 (57%) had no obvious underlying diseases, and 14 (32%) had preexisting neoplastic diseases or had previously used steroids. Twenty-five patients (57%) presented with cellulitis or necrotizing fasciitis, 24 (55%) had bacteremia, and eight (189%) had streptococcal toxic shock syndrome (STSS). Eight patients (18%) died of invasive GAS disease; seven had STSS, and seven had underlying diseases. All eight patients died within 48 hours after hospitalization. The presence of speA, speC, or speF was not implicated in any particular clinical syndrome in patients with invasive GAS disease. High- level protease activity and the M1 serotype of the isolates were significantly associated with the clinical signs of STSS and with mortality. M1 serotype and protease activity, as well as host immune status, might play significant roles in the pathogenesis of invasive GAS disease in Taiwan.

Original languageEnglish
Pages (from-to)584-589
Number of pages6
JournalClinical Infectious Diseases
Volume26
Issue number3
DOIs
Publication statusPublished - 1998 Jan 1

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases

Fingerprint Dive into the research topics of 'Invasive group a streptococcal disease in Taiwan is not associated with the presence of streptococcal pyrogenic exotoxin genes'. Together they form a unique fingerprint.

Cite this