Lother Sylvain A, Demczuk Walter, Martin Irene, Mulvey Michael, Dufault Brenden, Lagacé-Wiens Philippe, Keynan Yoav
Emerg Infect Dis. 2017 Jul;23(7):1079-1088. doi: 10.3201/eid2307.161259.
The incidence of group C and G Streptococcus (GCGS) bacteremia, which is associated with severe disease and death, is increasing. We characterized clinical features, outcomes, and genetic determinants of GCGS bacteremia for 89 patients in Winnipeg, Manitoba, Canada, who had GCGS bacteremia during 2012-2014. Of the 89 patients, 51% had bacteremia from skin and soft tissue, 70% had severe disease features, and 20% died. Whole-genome sequencing analysis was performed on isolates derived from 89 blood samples and 33 respiratory sample controls: 5 closely related genetic lineages were identified as being more likely to cause invasive disease than non-clade isolates (83% vs. 57%, p = 0.002). Virulence factors cbp, fbp, speG, sicG, gfbA, and bca clustered clonally into these clades. A clonal distribution of virulence factors may account for severe and fatal cases of bacteremia caused by invasive GCGS.
与严重疾病和死亡相关的C组和G组链球菌（GCGS）菌血症的发病率正在上升。我们对加拿大马尼托巴省温尼伯市89例在2012年至2014年期间发生GCGS菌血症的患者的临床特征、转归及基因决定因素进行了描述。89例患者中，51%的菌血症来自皮肤和软组织，70%有严重疾病特征，20%死亡。对来自89份血液样本和33份呼吸道样本对照的分离株进行了全基因组测序分析：确定了5个密切相关的基因谱系比非进化枝分离株更有可能引起侵袭性疾病（83%对57%，p = 0.002）。毒力因子cbp、fbp、speG、sicG、gfbA和bca在这些进化枝中呈克隆性聚集。毒力因子的克隆分布可能是侵袭性GCGS引起菌血症的严重和致命病例的原因。
