Trell Kristina, Sendi Parham, Rasmussen Magnus
The Division of Infection Medicine, Department of Clinical Sciences, Lund University, Sweden.
Department of Infectious Diseases, University Hospital Bern and University of Bern, Switzerland.
Diagn Microbiol Infect Dis. 2016 May;85(1):121-4. doi: 10.1016/j.diagmicrobio.2016.01.011. Epub 2016 Jan 22.
Beta-hemolytic streptococci of groups C and G, designated as Streptococcus dysgalactiae (SD), can cause severe and recurring invasive infections. In this case-control study, we aimed to identify clinical and molecular risk factors for recurrence of SD bacteremia. Twenty-two cases of recurrent SD bacteremia were identified, and median time between episodes was 6 months. The most frequent clinical manifestation was skin and soft tissue infection. Cases and 92 controls, with single-episode SD bacteremia, showed similar demographics, had similar Charlson comorbidity scores, and had similar clinical presentations. Thirty-day fatality was 13% among controls, whereas none of 22 cases died. In 19 cases (86%), the same emm type was encountered in both episodes. SD isolates from recurrent episodes and from single episodes had a similar emm type distribution. Thus, we did not identify clinical risk factors for recurrences. The high proportion of identical emm types in recurrent episodes indicates a host-specific colonization.
C组和G组β溶血性链球菌，即被称为停乳链球菌（SD），可引起严重且复发性侵袭性感染。在这项病例对照研究中，我们旨在确定SD菌血症复发的临床和分子危险因素。我们识别出22例复发性SD菌血症病例，发作间隔的中位数为6个月。最常见的临床表现是皮肤和软组织感染。病例组与92例单发性SD菌血症对照组在人口统计学特征、查尔森合并症评分及临床表现方面相似。对照组30天病死率为13%，而22例病例组无一死亡。19例（86%）病例的两次发作中遇到相同的emm型。复发性发作和单发性发作的SD分离株具有相似的emm型分布。因此，我们未识别出复发的临床危险因素。复发性发作中相同emm型的高比例表明存在宿主特异性定植。
