International Vaccine Institute, Seoul, Republic of Korea.
London School of Hygiene and Tropical Medicine, London, UK.
BMC Infect Dis. 2024 Jan 19;24(1):108. doi: 10.1186/s12879-023-08888-4.
The spectrum of diseases caused by Streptococcus pyogenes (Strep A) ranges from superficial to serious life-threatening invasive infections. We conducted a scoping review of published articles between 1980 and 2021 to synthesize evidence of state transitions across the Strep A disease spectrum. We identified 175 articles reporting 262 distinct observations of Strep A disease state transitions. Among the included articles, the transition from an invasive or toxin-mediated disease state to another disease state (i.e., to recurrent ARF, RHD or death) was described 115 times (43.9% of all included transition pairs) while the transition to and from locally invasive category was the lowest (n = 7; 0.02%). Transitions from well to any other state was most frequently reported (49%) whereas a relatively higher number of studies (n = 71) reported transition from invasive disease to death. Transitions from any disease state to locally invasive, Strep A pharyngitis to invasive disease, and chronic kidney disease to death were lacking. Transitions related to severe invasive diseases were more frequently reported than superficial ones. Most evidence originated from high-income countries and there is a critical need for new studies in low- and middle-income countries to infer the state transitions across the Strep A disease spectrum in these high-burden settings.
化脓性链球菌（A 组链球菌）引起的疾病范围从浅表到严重的危及生命的侵袭性感染。我们对 1980 年至 2021 年期间发表的文章进行了范围综述，以综合评估 A 组链球菌疾病谱中状态转变的证据。我们确定了 175 篇报告了 262 个 A 组链球菌疾病状态转变的独特观察结果的文章。在纳入的文章中，从侵袭性或毒素介导的疾病状态向另一种疾病状态（即复发性急性风湿热、风湿性心脏病或死亡）的转变描述了 115 次（所有纳入的转变对的 43.9%），而从局部侵袭性疾病类别向其他类别的转变最少（n=7；0.02%）。从良好状态到任何其他状态的转变报告最频繁（49%），而更多的研究（n=71）报告了从侵袭性疾病到死亡的转变。从任何疾病状态到局部侵袭性疾病、咽峡炎到侵袭性疾病、慢性肾病到死亡的转变缺乏报道。与严重侵袭性疾病相关的转变比浅表疾病更频繁地被报道。大多数证据来自高收入国家，迫切需要在低收入和中等收入国家开展新的研究，以推断这些高负担环境中 A 组链球菌疾病谱中的状态转变。
