title: Evaluation of streptococcal toxic shock-like syndrome caused by group B streptococcus in adults in Japan between 2009 and 2013.
abstract: Infection with Streptococcus agalactiae has long been recognized in infants. In recent years, S. agalactiae is an important cause of morbidity and mortality among adults and among those with underlying medical condition. Several cases of GBS infection and more fulminant disease similar to streptococcal toxic shock syndrome have recently been reported. We report here that 19 S. agalactiae strains were isolated from streptococcal toxic shock-like syndrome cases involving adult patients in Japan between 2009 and 2013. The average age of the patients was 66.3 years. At least one underlying disease was present in 47.4% (9/19) of the patients. The most prevalent serotype among these strains was Ib. All serotype Ib strains belonged to clonal complex 10 and were ciprofloxacin resistant. In contrast, all strains were susceptible to penicillin G, ampicillin, cefazolin, cefotaxime, imipenem, panipenem, and linezolid. The characteristic type distributions of streptococcal toxic shock-like syndrome isolates differed between isolates obtained from vaginal swabs of women and infants with invasive infections.
authors.affiliation: Department of Bacteriology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan. Electronic address: tdikebe@nih.go.jp.
authors.forename: Tadayoshi
authors.initials: T
authors.lastname: Ikebe
authors.affiliation: Department of Microbiology, Fukushima Institute of Public Health, 16-6 Mitouchi, Katakida, Fukushima 960-8560, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Chiba
authors.affiliation: Department of Bacteriology, Toyama Institute of Health, 17-1 Naka-Taikouyama, Imizu, Toyama 939-0363, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Shima
authors.affiliation: Department of Bacteriology, Toyama Institute of Health, 17-1 Naka-Taikouyama, Imizu, Toyama 939-0363, Japan.
authors.forename: Chieko
authors.initials: C
authors.lastname: Masuda
authors.affiliation: Department of Microbiology, Tokyo Metropolitan Institute of Public Health, 3-24-1 Hyakunin-cho, Shinjuku-ku, Tokyo 169-0073, Japan.
authors.forename: Rumi
authors.initials: R
authors.lastname: Okuno
authors.affiliation: Division of Microbiology, Kanagawa Prefectural Institute of Public Health, 1-3-1 Shimomachiya, Chigasaki, Kanagawa 253-0087, Japan.
authors.forename: Hitomi
authors.initials: H
authors.lastname: Ohya
authors.affiliation: Laboratory of Microbiology, Oita Prefectural Institute of Health and Environment, 2-8 Takae-Nishi, Oita 870-1117, Japan.
authors.forename: Kikuyo
authors.initials: K
authors.lastname: Ogata
authors.affiliation: Department of Infectious Diseases, Osaka Prefectural Institute of Public Health, 1-3-69 Nakamichi, Higashinari-ku, Osaka 537-0025, Japan.
authors.forename: Chihiro
authors.initials: C
authors.lastname: Katsukawa
authors.affiliation: Department of Infectious Diseases, Osaka Prefectural Institute of Public Health, 1-3-69 Nakamichi, Higashinari-ku, Osaka 537-0025, Japan.
authors.forename: Ryuji
authors.initials: R
authors.lastname: Kawahara
authors.affiliation: Department of Public Health Sciences, Yamaguchi Prefectural Institute of Public Health and Environment, 2-5-67 Aoi, Yamaguchi 753-0821, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Tominaga
authors.affiliation: Department of Public Health Sciences, Yamaguchi Prefectural Institute of Public Health and Environment, 2-5-67 Aoi, Yamaguchi 753-0821, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Yabata
authors.affiliation: Infectious Disease Surveillance Center, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Tada
authors.affiliation: Infectious Disease Surveillance Center, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan.
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Okabe
authors.affiliation: Department of Bacteriology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan.
authors.forename: Haruo
authors.initials: H
authors.lastname: Watanabe
authors.affiliation: Department of Bacteriology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan.
authors.forename: Bin
authors.initials: B
authors.lastname: Chang
authors.affiliation: Department of Bacteriology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan.
authors.forename: Michinaga
authors.initials: M
authors.lastname: Ogawa
authors.affiliation: Department of Bacteriology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Ohnishi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D065288:Serogroup; D012772:Shock, Septic / Q000382:microbiology*; D013290:Streptococcal Infections / Q000175:diagnosis*; D013292:Streptococcus agalactiae / Q000187:drug effects / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antimicrobial susceptibility; Group B streptococcus; Serotype; Streptococcal toxic shock-like syndrome