Oppegaard Oddvar, Mylvaganam Haima, Skrede Steinar, Jordal Stina, Glambek Marte, Kittang Bård Reiakvam
Department of Medicine, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway.
Department of Microbiology, Haukeland University Hospital, Bergen, Norway.
Diagn Microbiol Infect Dis. 2017 Oct;89(2):135-142. doi: 10.1016/j.diagmicrobio.2017.06.015. Epub 2017 Jun 30.
Streptococcus pyogenes (S. pyogenes) and Streptococcus dysgalactiae subspecies equisimilis (SDSE) cause considerable morbidity and mortality, and show similarities in disease manifestations and pathogenic mechanisms. Their involvement in infective endocarditis, however, has not been well described. Invasive S. pyogenes and SDSE infections in Health Region Bergen, Norway, in the period 1999-2013 were reviewed, and sixteen cases of endocarditis were identified. The median duration of symptoms was 2.5days, the frequency of embolic events 50%, 38% received valve replacement and the 30-day mortality was 25%. In S. pyogenes, a significant correlation was observed between the repertoire of fibronectin-binding genes, phenotypic binding ability to fibronectin and disease manifestations. Conversely, no associations between phenotypic and genotypic characteristics were detected in SDSE. S. pyogenes and SDSE endocarditis is characterized by rapid and severe clinical manifestations. The pathogenesis is multifactorial, but our results infer a potential role of fibronectin binding in the development of S. pyogenes endocarditis.
化脓性链球菌（A 组链球菌）和马链球菌兽疫亚种（SDSE）可导致相当高的发病率和死亡率，且在疾病表现和致病机制上存在相似性。然而，它们与感染性心内膜炎的关联尚未得到充分描述。对挪威卑尔根健康地区 1999 年至 2013 年期间侵袭性 A 组链球菌和 SDSE 感染进行了回顾，共确定了 16 例心内膜炎病例。症状的中位持续时间为 2.5 天，栓塞事件的发生率为 50%，38%的患者接受了瓣膜置换，30 天死亡率为 25%。在 A 组链球菌中，观察到纤连蛋白结合基因库、纤连蛋白表型结合能力与疾病表现之间存在显著相关性。相反，在 SDSE 中未检测到表型和基因型特征之间的关联。A 组链球菌和 SDSE 心内膜炎的特点是临床表现迅速且严重。发病机制是多因素的，但我们的结果推断纤连蛋白结合在 A 组链球菌心内膜炎的发展中可能起作用。
