Holm S E, Norrby A, Bergholm A M, Norgren M
Department of Clinical Bacteriology, University of Umeå, Sweden.
J Infect Dis. 1992 Jul;166(1):31-7. doi: 10.1093/infdis/166.1.31.
Serotypes of serious, sometimes fatal, streptococcal infections in Sweden during 1988-1989 were analyzed. The T1M1 type totally dominated, representing almost 70% of all group A streptococci from serious and uncomplicated infections at the peak of the outbreak. Immunoblots of isolates from various patient groups showed that all isolates produced high amounts of erythrogenic toxin (ET) B and high amounts of ET-C, whereas ET-A was released only in small amounts and from few isolates. ELISAs showed high antibody levels to these toxins and to the M1 antigen in patients with uncomplicated infections. Low antibody levels against M1 were seen in patients with bacteremia and in fatal cases; the latter also had low antibody levels against ET-B. It seems likely that a combination of production of large amounts of toxin and low antibody titers to it and to the M antigen of the infecting isolate are determining factors for the outcome of the infection. No signs of primary immune deficiency were noted.
对1988 - 1989年瑞典严重的、有时甚至致命的链球菌感染血清型进行了分析。T1M1型占主导地位，在疫情高峰期，几乎占所有来自严重和非复杂性感染的A组链球菌的70%。对不同患者群体分离株的免疫印迹分析表明，所有分离株均产生大量的致热外毒素（ET）B和大量的ET - C，而ET - A仅少量释放且只有少数分离株产生。酶联免疫吸附测定显示，非复杂性感染患者对这些毒素和M1抗原有较高的抗体水平。菌血症患者和死亡病例中针对M1的抗体水平较低；后者对ET - B的抗体水平也较低。大量毒素的产生以及对毒素和感染分离株M抗原的低抗体滴度相结合，似乎是感染结果的决定因素。未发现原发性免疫缺陷的迹象。
