AFROStrep Research Group, Department of Medicine and Cape Heart Institute, University of Cape Town, Cape Town, South Africa.
Department of Pathology, Division of Medical Microbiology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
Front Cell Infect Microbiol. 2024 Jun 3;14:1337861. doi: 10.3389/fcimb.2024.1337861. eCollection 2024.
It is currently unclear what the role of Group A streptococcus (GAS) virulence factors (VFs) is in contributing to the invasive potential of GAS. This work investigated the evidence for the association of GAS VFs with invasive disease.
We employed a broad search strategy for studies reporting the presence of GAS VFs in invasive and non-invasive GAS disease. Data were independently extracted by two reviewers, quality assessed, and meta-analyzed using Stata®.
A total of 32 studies reported on 45 putative virulence factors [invasive (n = 3,236); non-invasive (n = 5,218)], characterized by polymerase chain reaction (PCR) (n = 30) and whole-genome sequencing (WGS) (n = 2). The risk of bias was rated as low and moderate, in 23 and 9 studies, respectively. Meta-,analyses of high-quality studies (n = 23) revealed a significant association of [OR, 1.64 (95%CI, 1.06; 2.52)] with invasive infection. Meta-analysis of WGS studies demonstrated a significant association of [OR, 1.91 (95%CI, 1.36; 2.67)] and [OR, 2.83 (95%CI, 1.63; 4.92)] with invasive GAS (iGAS). Meta-analysis of PCR studies indicated a significant association of [OR, 1.59 (95%CI, 1.10; 2.30)] and [OR, 2.95 (95%CI, 1.81; 4.80)] with invasive infection. A significant inverse association was observed between [OR, 0.42 (95%CI, 0.20; 0.87)] and invasive infection.
This systematic review and genomic meta-analysis provides evidence of a statistically significant association with invasive infection for the gene, while , , , , , and show statistically significantly inverse associations with invasive infection. , , and are associated with GAS virulence; however, it is unclear if they are markers of invasive infection. This work could possibly aid in developing preventative strategies.
目前尚不清楚 A 组链球菌（GAS）毒力因子（VF）在其侵袭潜能中的作用。本研究旨在探讨 GAS VF 与侵袭性疾病之间的关联。
我们采用了广泛的搜索策略，以寻找报道 GAS VF 在侵袭性和非侵袭性 GAS 疾病中存在的研究。数据由两名评审员独立提取，使用 Stata®进行质量评估和荟萃分析。
共有 32 项研究报告了 45 种潜在的毒力因子[侵袭性（n = 3236）；非侵袭性（n = 5218）]，通过聚合酶链反应（PCR）（n = 30）和全基因组测序（WGS）（n = 2）进行鉴定。23 项研究的偏倚风险被评为低风险，9 项研究被评为中风险。荟萃分析高质量研究（n = 23）显示，与侵袭性感染显著相关的是 [比值比（OR），1.64（95%可信区间，1.06；2.52）]。WGS 研究的荟萃分析表明，与侵袭性 GAS（iGAS）显著相关的是 [OR，1.91（95%可信区间，1.36；2.67）] 和 [OR，2.83（95%可信区间，1.63；4.92）]。PCR 研究的荟萃分析表明，与侵袭性感染显著相关的是 [OR，1.59（95%可信区间，1.10；2.30）] 和 [OR，2.95（95%可信区间，1.81；4.80）]。还观察到与侵袭性感染显著负相关的是 [OR，0.42（95%可信区间，0.20；0.87）]。
本系统评价和基因组荟萃分析提供了证据，表明 基因与侵袭性感染存在统计学显著关联，而 、 、 、 、 和 与侵袭性感染呈统计学显著负相关。 、 和 与 GAS 毒力有关；然而，尚不清楚它们是否是侵袭性感染的标志物。这项工作可能有助于制定预防策略。
