title: [Epidemiology of Streptococcus pyogenes invasive diseases in France (2007-2011)].
abstract: Group A Streptococcus (GAS) is a human pathogen responsible for a wide range of clinical manifestations. An increase of GAS invasive infections has been described since the mid 1980s. To study the French epidemiology of invasive infections (i) we characterized all GAS invasive strains received at the French National Reference Center for streptococci (CNR-Strep) between 2007 and 2011; (ii) we analyzed the epidemiological data on the corresponding strains. For each strain, emm genotype, superantigen genes and antibiotics susceptibility were determined. Among the 2 603 non redundant invasive GAS strains, 65.1 % (n=1 695) were isolated from blood culture. A streptococcal toxic shock syndrome (STSS) was described in 16.4 % (n=428) of cases, mostly associated with necrotizing fasciitis (NF), pleuropulmonary or osteoarticular infections (p ≤0.001). The case fatality rate was 10.6 %. A total of 102 different emm genotypes were identified. Three emm genotypes predominated, reaching nearly 60 % of the strains: emm 1 (26.7 %), emm 28 (16.4 %), and emm 89 (12.8 %). The proportion of each emm genotype varied according to the year and the age of patients. Among those < 15 years old, the three main genotypes were emm 1 (36.8 %), emm 12 (12.9 %) and emm 4 (9.5 %). The distribution of superantigen genes (SpeA, SpeC and Ssa) was restricted to several emm genotypes. Between 2007 and 2011, the rate of macrolides resistant GAS strains decreased from 7.8 to 5.5 %. emm 1 strains are still the most common especially in most severe clinical manifestations including STSS and NF.
authors.affiliation: Service de bactériologie, centre national de référence des streptocoques, groupe hospitalier Cochin-Hôtel-Dieu-Broca (AP-HP), 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Faculté de médecine, université Paris-Descartes, 15, rue de l'École-de-Médecine, 75006 Paris, France; INSERM 1016, institut Cochin, 22, rue Méchain, 75014 Paris, France; CNRS, UMR 8104, biologie cellulaire, institut Cochin, 22, rue Méchain, 75014 Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Plainvert
authors.affiliation: Service de bactériologie, centre national de référence des streptocoques, groupe hospitalier Cochin-Hôtel-Dieu-Broca (AP-HP), 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Faculté de médecine, université Paris-Descartes, 15, rue de l'École-de-Médecine, 75006 Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Loubinoux
authors.affiliation: Service de microbiologie, hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France; Faculté de médecine, université Paris-Diderot, PRES Sorbonne-Paris-Cité, 46, rue Henri-Huchard, 75018 Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Bidet
authors.affiliation: Service de bactériologie, centre national de référence des streptocoques, groupe hospitalier Cochin-Hôtel-Dieu-Broca (AP-HP), 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Doloy
authors.affiliation: Service de bactériologie, centre national de référence des streptocoques, groupe hospitalier Cochin-Hôtel-Dieu-Broca (AP-HP), 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Touak
authors.affiliation: Service de bactériologie, centre national de référence des streptocoques, groupe hospitalier Cochin-Hôtel-Dieu-Broca (AP-HP), 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.
authors.forename: N
authors.initials: N
authors.lastname: Dmytruk
authors.affiliation: Service de bactériologie, centre national de référence des streptocoques, groupe hospitalier Cochin-Hôtel-Dieu-Broca (AP-HP), 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Collobert
authors.affiliation: Service de microbiologie, hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France; Faculté de médecine, université Paris-Diderot, PRES Sorbonne-Paris-Cité, 46, rue Henri-Huchard, 75018 Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Bingen
authors.affiliation: Service de bactériologie, centre national de référence des streptocoques, groupe hospitalier Cochin-Hôtel-Dieu-Broca (AP-HP), 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Faculté de médecine, université Paris-Descartes, 15, rue de l'École-de-Médecine, 75006 Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Bouvet
authors.affiliation: INSERM 1016, institut Cochin, 22, rue Méchain, 75014 Paris, France; CNRS, UMR 8104, biologie cellulaire, institut Cochin, 22, rue Méchain, 75014 Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Fouet
authors.affiliation: Service de bactériologie, centre national de référence des streptocoques, groupe hospitalier Cochin-Hôtel-Dieu-Broca (AP-HP), 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Faculté de médecine, université Paris-Descartes, 15, rue de l'École-de-Médecine, 75006 Paris, France; INSERM 1016, institut Cochin, 22, rue Méchain, 75014 Paris, France; CNRS, UMR 8104, biologie cellulaire, institut Cochin, 22, rue Méchain, 75014 Paris, France. Electronic address: claire.poyart@cch.aphp.fr.
authors.forename: C
authors.initials: C
authors.lastname: Poyart
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D019115:Fasciitis, Necrotizing / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D005602:France / Q000453:epidemiology; D005838:Genotype; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011001:Pleuropneumonia / Q000453:epidemiology / Q000382:microbiology; D012772:Shock, Septic / Q000453:epidemiology / Q000382:microbiology; D013290:Streptococcal Infections / Q000188:drug therapy / Q000453:epidemiology*; D013297:Streptococcus pyogenes / Q000235:genetics / Q000302:isolation & purification*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents