Streptococcal toxic shock syndrome caused by the dissemination of an invasive emm3/ST15 strain of Streptococcus pyogenes

BMC Infect Dis. 2017 Dec 18;17(1):774. doi: 10.1186/s12879-017-2870-2.

Abstract

Background: Streptococcus pyogenes (group A Streptococcus [GAS]) is a major human pathogen that causes a wide spectrum of clinical manifestations. Although invasive GAS (iGAS) infections are relatively uncommon, emm3/ST15 GAS is a highly virulent, invasive, and pathogenic strain. Global molecular epidemiology analysis has suggested that the frequency of emm3 GAS has been recently increasing.

Case presentation: A 14-year-old patient was diagnosed with streptococcal toxic shock syndrome and severe pneumonia, impaired renal function, and rhabdomyolysis. GAS was isolated from a culture of endotracheal aspirates and designated as KS030. Comparative genome analysis suggested that KS030 is classified as emm3 (emm-type) and ST15 (multilocus sequencing typing [MLST]), which is similar to iGAS isolates identified in the UK (2013) and Switzerland (2015).

Conclusions: We conclude that the global dissemination of emm3/ST15 GAS strain has the potential to cause invasive disease.

Keywords: Invasive; ST15; Streptococcus pyogenes; Whole-genome sequencing; emm3.

MeSH terms

  • Antigens, Bacterial / genetics
  • Bacterial Outer Membrane Proteins / genetics
  • Humans
  • Molecular Epidemiology
  • Multilocus Sequence Typing
  • Shock, Septic / epidemiology
  • Shock, Septic / microbiology*
  • Streptococcal Infections / epidemiology
  • Streptococcal Infections / microbiology*
  • Streptococcus pyogenes / classification
  • Streptococcus pyogenes / genetics
  • Streptococcus pyogenes / isolation & purification*
  • Switzerland / epidemiology

Substances

  • Antigens, Bacterial
  • Bacterial Outer Membrane Proteins