title: Increased prevalence of group A streptococcus isolates in streptococcal toxic shock syndrome cases in Japan from 2010 to 2012.
abstract: Streptococcal toxic shock syndrome (STSS) is a severe invasive infection characterized by the sudden onset of shock, multi-organ failure, and high mortality. In Japan, appropriate notification measures based on the Infectious Disease Control law are mandatory for cases of STSS caused by β-haemolytic streptococcus. STSS is mainly caused by group A streptococcus (GAS). Although an average of 60-70 cases of GAS-induced STSS are reported annually, 143 cases were recorded in 2011. To determine the reason behind this marked increase, we characterized the emm genotype of 249 GAS isolates from STSS patients in Japan from 2010 to 2012 and performed antimicrobial susceptibility testing. The predominant genotype was found to be emm1, followed by emm89, emm12, emm28, emm3, and emm90. These six genotypes constituted more than 90% of the STSS isolates. The number of emm1, emm89, emm12, and emm28 isolates increased concomitantly with the increase in the total number of STSS cases. In particular, the number of mefA-positive emm1 isolates has escalated since 2011. Thus, the increase in the incidence of STSS can be attributed to an increase in the number of cases associated with specific genotypes.
authors.affiliation: Department of Bacteriology I,National Institute of Infectious Diseases,Toyama, Shinjuku-ku, Tokyo,Japan.
authors.forename: T
authors.initials: T
authors.lastname: Ikebe
authors.affiliation: Department of Public Health Sciences,Yamaguchi Prefectural Institute of Public Health and Environment,Yamaguchi,Japan.
authors.forename: K
authors.initials: K
authors.lastname: Tominaga
authors.affiliation: Department of Bacteriology,Toyama Institute of Health,Toyama,Japan.
authors.forename: T
authors.initials: T
authors.lastname: Shima
authors.affiliation: Department of Microbiology,Tokyo Metropolitan Institute of Public Health,Tokyo,Japan.
authors.forename: R
authors.initials: R
authors.lastname: Okuno
authors.affiliation: Department of Microbiology,Tokyo Metropolitan Institute of Public Health,Tokyo,Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kubota
authors.affiliation: Laboratory of Microbiology,Oita Prefectural Institute of Health and Environment,Oita,Japan.
authors.forename: K
authors.initials: K
authors.lastname: Ogata
authors.affiliation: Department of Microbiology,Fukushima Institute of Public Health,Fukushima,Japan.
authors.forename: K
authors.initials: K
authors.lastname: Chiba
authors.affiliation: Department of Infectious Diseases,Osaka Prefectural Institute of Public Health,Osaka,Japan.
authors.forename: C
authors.initials: C
authors.lastname: Katsukawa
authors.affiliation: Division of Microbiology,Kanagawa Prefectural Institute of Public Health,Kanagawa,Japan.
authors.forename: H
authors.initials: H
authors.lastname: Ohya
authors.affiliation: Infectious Disease Surveillance Center,National Institute of Infectious Diseases,Tokyo,Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Tada
authors.affiliation: Infectious Disease Surveillance Center,National Institute of Infectious Diseases,Tokyo,Japan.
authors.forename: N
authors.initials: N
authors.lastname: Okabe
authors.affiliation: Department of Bacteriology I,National Institute of Infectious Diseases,Toyama, Shinjuku-ku, Tokyo,Japan.
authors.forename: H
authors.initials: H
authors.lastname: Watanabe
authors.affiliation: Department of Bacteriology I,National Institute of Infectious Diseases,Toyama, Shinjuku-ku, Tokyo,Japan.
authors.forename: M
authors.initials: M
authors.lastname: Ogawa
authors.affiliation: Department of Bacteriology I,National Institute of Infectious Diseases,Toyama, Shinjuku-ku, Tokyo,Japan.
authors.forename: M
authors.initials: M
authors.lastname: Ohnishi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002981:Clindamycin / Q000494:pharmacology; D024881:Drug Resistance, Bacterial / Q000235:genetics; D004917:Erythromycin / Q000494:pharmacology; D005260:Female; D005838:Genotype; D006801:Humans; D007223:Infant; D007564:Japan / Q000453:epidemiology; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015995:Prevalence; D012772:Shock, Septic / Q000453:epidemiology* / Q000382:microbiology; D013290:Streptococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D013297:Streptococcus pyogenes / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification; D055815:Young Adult
chemical_list: D002981:Clindamycin; D004917:Erythromycin
keywords: streptococcal toxic shock syndrome