title: Recurrent bacteremia with Streptococcus dysgalactiae: a case-control study.
abstract: Beta-hemolytic streptococci of groups C and G, designated as Streptococcus dysgalactiae (SD), can cause severe and recurring invasive infections. In this case-control study, we aimed to identify clinical and molecular risk factors for recurrence of SD bacteremia. Twenty-two cases of recurrent SD bacteremia were identified, and median time between episodes was 6 months. The most frequent clinical manifestation was skin and soft tissue infection. Cases and 92 controls, with single-episode SD bacteremia, showed similar demographics, had similar Charlson comorbidity scores, and had similar clinical presentations. Thirty-day fatality was 13% among controls, whereas none of 22 cases died. In 19 cases (86%), the same emm type was encountered in both episodes. SD isolates from recurrent episodes and from single episodes had a similar emm type distribution. Thus, we did not identify clinical risk factors for recurrences. The high proportion of identical emm types in recurrent episodes indicates a host-specific colonization.
authors.affiliation: The Division of Infection Medicine, Department of Clinical Sciences, Lund University, Sweden.
authors.forename: Kristina
authors.initials: K
authors.lastname: Trell
authors.affiliation: Department of Infectious Diseases, University Hospital Bern and University of Bern, Switzerland.
authors.forename: Parham
authors.initials: P
authors.lastname: Sendi
authors.affiliation: The Division of Infection Medicine, Department of Clinical Sciences, Lund University, Sweden. Electronic address: Magnus.Rasmussen@med.lu.se.
authors.forename: Magnus
authors.initials: M
authors.lastname: Rasmussen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia; D015373:Bacterial Typing Techniques; D016022:Case-Control Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D012008:Recurrence; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; D013290:Streptococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D013291:Streptococcus / Q000145:classification* / Q000235:genetics
keywords: Bacteremia; Beta-hemolytic streptococci; Recurrent bacteremia; Streptococcus dysgalactiae; emm-type