Imöhl Matthias, Reinert Ralf René, Ocklenburg Christina, van der Linden Mark
National Reference Center for Streptococci, Institute of Medical Microbiology, University Hospital, Aachen, Germany.
FEMS Immunol Med Microbiol. 2010 Apr;58(3):389-96. doi: 10.1111/j.1574-695X.2010.00652.x. Epub 2010 Jan 19.
A nationwide laboratory-based surveillance study of invasive Streptococcus pyogenes infections was conducted in Germany. Invasive isolates (n=586) were obtained between 2003 and 2007. Most isolates were obtained from blood (53.9%) or skin lesions (17.6%). The most common emm types were emm 1 (30.5%), emm 28 (18.3%) and emm 3 (9.6%). Overall, speA was positive in 45.9%, speC in 44.7% and ssa in 14.8% of isolates. SpeA was common in emm type 1 (100%) and emm type 3 (96.4%), whereas speC was often observed in emm type 28 (93.5%). The most frequent clinical manifestations included sepsis (40.1%), necrotizing fasciitis (20.8%) and streptococcal toxic shock syndrome (16.6%). All isolates were susceptible to penicillin G, cefotaxime and levofloxacin. Tetracycline shows the highest rate of resistant or intermediate isolates with 11.6%, followed by clarithromycin (5.5%) and clindamycin (1.2%). The most prominent trend is the reduction of tetracycline-nonsusceptible isolates from 18.6% in 2003 to 8.9% in 2007.
在德国开展了一项基于实验室的全国性侵袭性酿脓链球菌感染监测研究。在2003年至2007年期间获取了侵袭性分离株（n = 586）。大多数分离株来自血液（53.9%）或皮肤损伤处（17.6%）。最常见的emm型为emm 1（30.5%）、emm 28（18.3%）和emm 3（9.6%）。总体而言，45.9%的分离株speA呈阳性，44.7%的分离株speC呈阳性，14.8%的分离株ssa呈阳性。SpeA在emm 1型（100%）和emm 3型（96.4%）中常见，而speC在emm 28型中经常观察到（93.5%）。最常见的临床表现包括败血症（40.1%）、坏死性筋膜炎（20.8%）和链球菌中毒性休克综合征（16.6%）。所有分离株对青霉素G、头孢噻肟和左氧氟沙星敏感。四环素耐药或中介分离株的比例最高，为11.6%，其次是克拉霉素（5.5%）和克林霉素（1.2%）。最显著的趋势是四环素不敏感分离株从2003年的18.6%降至2007年的8.9%。
