Wheeler M C, Roe M H, Kaplan E L, Schlievert P M, Todd J K
Section of Epidemiology, Children's Hospital, Denver, CO 80218.
JAMA. 1991;266(4):533-7.
To determine the epidemiologic, clinical, and microbiological features of group A streptococcus septicemia in children.
A descriptive series of 34 cases over an 11-year period from 1980 through 1990.
An academically affiliated tertiary-care pediatric hospital, the principal referral center for the state of Colorado and surrounding states.
Thirty-four patients with positive blood cultures for group A streptococcus (33 medical records were available).
Yearly incidence and clinical features of cases; microbiological features of isolated organisms.
There was a significant increase (P = .01) in the incidence of group A streptococcus bacteremia over an 11-year period, with 14 (41%) of these cases occurring in 1989 and 1990. Patients had a rapidly progressing illness, usually without preceding pharyngitis. The prominent M and T types were 1 (4) and 12 (4). Eleven (73%) of the 15 strains produced pyrogenic exotoxin B that significantly correlated with production of proteinase.
There appears to be an increase in group A streptococcus bacteremia in children that is associated with a strain phenotype that suggests a change in organism virulence.
确定儿童A组链球菌败血症的流行病学、临床和微生物学特征。
对1980年至1990年11年间的34例病例进行描述性系列研究。
一家隶属于学术机构的三级护理儿童医院，是科罗拉多州及周边州的主要转诊中心。
34例血培养A组链球菌阳性的患者（有33份病历）。
病例的年发病率和临床特征；分离菌株的微生物学特征。
在11年期间，A组链球菌菌血症的发病率显著增加（P = .01），其中14例（41%）发生在1989年和1990年。患者病情进展迅速，通常无前驱咽炎。主要的M型和T型分别为1型（4例）和12型（4例）。15株菌株中有11株（73%）产生致热外毒素B，与蛋白酶的产生显著相关。
儿童A组链球菌菌血症似乎有所增加，这与一种表明菌株毒力变化的菌株表型有关。
