title: Association of exotoxin-producing group A streptococci and severe disease in children.
abstract: Clinical features and microbiologic data on all cases of serious (hospitalized) Group A streptococcal infections in children managed at our institution between 1985 and 1988 are presented. All 6 cases were caused by toxin-producing strains. Four of 6 were toxin A-producing strains whereas none of 58 community-acquired (Group A streptococcal) pharyngeal isolates in the same period was a toxin A producer. A review of the literature on the incidence of toxin A-producing strains provides information suggesting a resurgence of such strains in the late 1980s after a relative disappearance of toxin B production in isolates from these patients was also significantly greater than in the isolates acquired from the community in uncomplicated pharyngitis. These findings suggest a role for exotoxin in severe manifestations of Group A streptococcal disease in children.
authors.affiliation: Department of Pediatrics, University of Minnesota Medical School, MN.
authors.forename: K
authors.initials: K
authors.lastname: Belani
authors.forename: P M
authors.initials: PM
authors.lastname: Schlievert
authors.forename: E L
authors.initials: EL
authors.lastname: Kaplan
authors.forename: P
authors.initials: P
authors.lastname: Ferrieri
mesh_terms: D000293:Adolescent; D002481:Cellulitis / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D004211:Disseminated Intravascular Coagulation / Q000209:etiology; D005098:Exotoxins / Q000096:biosynthesis*; D005260:Female; D005734:Gangrene / Q000209:etiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008910:Minnesota / Q000453:epidemiology; D015995:Prevalence; D018805:Sepsis / Q000382:microbiology; D013290:Streptococcal Infections / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology*; D013297:Streptococcus pyogenes / Q000302:isolation & purification*
chemical_list: D005098:Exotoxins