Norton R, Smith H V, Wood N, Siegbrecht E, Ross A, Ketheesan N
Microbiology, Queensland Health Pathology Services, Townsville Hospital, Townsville, Australia.
Indian J Med Res. 2004 May;119 Suppl:148-51.
BACKGROUND & OBJECTIVES: The incidence of group A streptococcal (GAS) invasive infections have been increasing worldwide. The aim of this study was to characterize clinical and microbiological features of isolates obtained from invasive GAS infections in North Queensland, Australia between 1996 and 2001.
Clinical and demographic data were collected prospectively. Isolates were biotyped, emm sequenced, M typed and tested for antibiotic sensitivity using E-test. Detection of the presence of the streptococcal pyrogenic exotoxin (spe) and fibronectin binding protein (prtF1) genes was also carried out.
There were 109 isolates from blood and sterile sites. All isolates were sensitive to penicillin. Tetracycline and erythromycin resistance was seen in 11 and 2.7 per cent of isolates respectively. The isolates were evenly distributed by age and sex. The overall mortality was 7 per cent and there were 18 cases of streptococcal toxic shock syndrome (STSS) in which the mortality was 22 per cent. Indigenous patients had a crude incidence rate of 82.5 per 100,000 per year compared with 10.3 per 100,000 per year in the non-indigenous patients. There was no predominance of emm / M type or association of spe type with STSS. There was also no relationship between the presence of the prtF1 gene and invasive disease.
INTERPRETATION & CONCLUSION: Invasive group A streptococci from North Queensland are similar to those from the Northern Territory of Australia in that no single strain is predominant. The indigenous population is overrepresented. Invasiveness and the development of streptococcal toxic shock is not related to the presence of the prtF1 gene or spe a or c.
A 组链球菌（GAS）侵袭性感染的发病率在全球范围内呈上升趋势。本研究旨在描述 1996 年至 2001 年期间在澳大利亚北昆士兰从侵袭性 GAS 感染中分离出的菌株的临床和微生物学特征。
前瞻性收集临床和人口统计学数据。对分离株进行生物分型、emm 测序、M 分型，并使用 E-test 检测抗生素敏感性。还检测了链球菌致热外毒素（spe）和纤连蛋白结合蛋白（prtF1）基因的存在情况。
从血液和无菌部位分离出 109 株菌株。所有分离株对青霉素敏感。分别有 11%和 2.7%的分离株对四环素和红霉素耐药。分离株在年龄和性别上分布均匀。总体死亡率为 7%，有 18 例链球菌中毒性休克综合征（STSS），其中死亡率为 22%。土著患者的年粗发病率为每 10 万人 82.5 例，而非土著患者为每 10 万人 10.3 例。emm/M 型没有优势，spe 型与 STSS 也没有关联。prtF1 基因的存在与侵袭性疾病之间也没有关系。
来自北昆士兰的侵袭性 A 组链球菌与来自澳大利亚北部地区的相似，即没有单一菌株占主导。土著人口比例过高。侵袭性和链球菌中毒性休克的发生与 prtF1 基因或 spe a 或 c 的存在无关。
