Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
European Journal of Clinical Microbiology & Infectious Diseases
Published in: European Journal of Clinical Microbiology & Infectious Diseases 8/2014

01-08-2014 | Review

Streptococcus dysgalactiae subsp. equisimilis bacteremia: an emerging infection

Author: S. Rantala

Published in: European Journal of Clinical Microbiology & Infectious Diseases | Issue 8/2014

Login to get access

Abstract

The importance of group C and G Streptococcus dysgalactiae subspecies equisimilis (S. dysgalactiae subsp. equisimilis) as a significant pathogen has recently been better recognized. S. dysgalactiae subsp. equisimilis disease can range in severity from milder skin and soft-tissue conditions such as wound infection, erysipelas, and cellulitis, to life-threatening necrotizing fasciitis and streptococcal toxic shock syndrome, thus sharing the clinical picture with S. pyogenes. The most common clinical manifestation of bacteremia is cellulitis. An increase in the incidence of S. dysgalactiae subsp. equisimilis bacteremia has been recognized. Invasive forms of this infection are most commonly found in elderly patients with underlying comorbidities and skin breakdown. The case fatality in bacteremia has been reported to be 15–18 %. In this review, the epidemiology, clinical characteristics, and emm types of S. dysgalactiae subsp. equisimilis bacteremia are summarized.
Literature
1.
2.
Vandamme P, Pot B, Falsen E, Kersters K, Devriese LA (1996) Taxonomic study of lancefield streptococcal groups C, G, and L (Streptococcus dysgalactiae) and proposal of S. dysgalactiae subsp. equisimilis subsp. nov. Int J Syst Bacteriol 46:774–781PubMedCrossRef
3.
Vieira VV, Teixeira LM, Zahner V et al (1998) Genetic relationships among the different phenotypes of Streptococcus dysgalactiae strains. Int J Syst Bacteriol 48(Pt 4):1231–1243PubMedCrossRef
4.
5.
Brandt CM, Spellerberg B (2009) Human infections due to Streptococcus dysgalactiae subspecies equisimilis. Clin Infect Dis 49:766–772PubMedCrossRef
6.
Broyles LN, Van Beneden C, Beall B et al (2009) Population-based study of invasive disease due to beta-hemolytic streptococci of groups other than A and B. Clin Infect Dis 48:706–712PubMedCrossRef
7.
Nei T, Akutsu K, Shima A et al (2012) A case of streptococcal toxic shock syndrome due to Group G streptococci identified as Streptococcus dysgalactiae subsp. equisimilis. J Infect Chemother 18:919–924PubMedCrossRef
8.
Haidan A, Talay SR, Rohde M, Sriprakash KS, Currie BJ, Chhatwal GS (2000) Pharyngeal carriage of group C and group G streptococci and acute rheumatic fever in an aboriginal population. Lancet 356:1167–1169PubMedCrossRef
9.
Reid HF, Bassett DC, Poon-King T, Zabriskie JB, Read SE (1985) Group G streptococci in healthy school-children and in patients with glomerulonephritis in Trinidad. J Hyg (Lond) 94:61–68CrossRef
10.
Ekelund K, Skinhøj P, Madsen J, Konradsen HB (2005) Invasive group A, B, C and G streptococcal infections in Denmark 1999–2002: epidemiological and clinical aspects. Clin Microbiol Infect 11:569–576PubMedCrossRef
11.
Rantala S, Vuopio-Varkila J, Vuento R, Huhtala H, Syrjänen J (2009) Clinical presentations and epidemiology of beta-haemolytic streptococcal bacteraemia: a population-based study. Clin Microbiol Infect 15:286–288PubMedCrossRef
12.
Auckenthaler R, Hermans PE, Washington JA 2nd (1983) Group G streptococcal bacteremia: clinical study and review of the literature. Rev Infect Dis 5:196–204PubMedCrossRef
13.
14.
Sylvetsky N, Raveh D, Schlesinger Y, Rudensky B, Yinnon AM (2002) Bacteremia due to beta-hemolytic Streptococcus group G: increasing incidence and clinical characteristics of patients. Am J Med 112:622–626PubMedCrossRef
15.
Takahashi T, Sunaoshi K, Sunakawa K et al (2010) Clinical aspects of invasive infections with Streptococcus dysgalactiae ssp. equisimilis in Japan: differences with respect to Streptococcus pyogenes and Streptococcus agalactiae infections. Clin Microbiol Infect 16:1097–1103PubMedCrossRef
16.
Rantala S, Vuopio-Varkila J, Vuento R, Huhtala H, Syrjänen J (2009) Predictors of mortality in beta-hemolytic streptococcal bacteremia: a population-based study. J Infect 58:266–272PubMedCrossRef
17.
Kittang BR, Bruun T, Langeland N, Mylvaganam H, Glambek M, Skrede S (2011) Invasive group A, C and G streptococcal disease in western Norway: virulence gene profiles, clinical features and outcomes. Clin Microbiol Infect 17:358–364PubMedCrossRef
18.
Bruun T, Kittang BR, de Hoog BJ et al (2013) Necrotizing soft tissue infections caused by Streptococcus pyogenes and Streptococcus dysgalactiae subsp. equisimilis of groups C and G in western Norway. Clin Microbiol Infect 19:E545–E550PubMedCrossRef
19.
Loubinoux J, Plainvert C, Collobert G et al (2013) Adult invasive and noninvasive infections due to Streptococcus dysgalactiae subsp. equisimilis in France from 2006 to 2010. J Clin Microbiol 51:2724–2727PubMedCentralPubMedCrossRef
20.
21.
Rantala S, Vahakuopus S, Vuopio-Varkila J, Vuento R, Syrjanen J (2010) Streptococcus dysgalactiae subsp. equisimilis bacteremia, Finland, 1995–2004. Emerg Infect Dis 16:843–846PubMedCentralPubMedCrossRef
22.
Vartian C, Lerner PI, Shlaes DM, Gopalakrishna KV (1985) Infections due to Lancefield group G streptococci. Medicine (Baltimore) 64:75–88CrossRef
23.
Barnham MR, Weightman NC (2004) Changing incidence of detected streptococcal bacteraemia in North Yorkshire, England. Indian J Med Res 119(Suppl):160–163PubMed
24.
Rantala S (2012) A population-based study of beta-hemolytic streptococcal bacteremia: Epidemiological, clinical and molecular characteristics. Doctoral thesis. Tampere University Press, Tampere
25.
Davies MR, McMillan DJ, Beiko RG et al (2007) Virulence profiling of Streptococcus dysgalactiae subspecies equisimilis isolated from infected humans reveals 2 distinct genetic lineages that do not segregate with their phenotypes or propensity to cause diseases. Clin Infect Dis 44:1442–1454PubMedCrossRef
26.
27.
Woo PC, Fung AM, Lau SK, Wong SS, Yuen KY (2001) Group G beta-hemolytic streptococcal bacteremia characterized by 16S ribosomal RNA gene sequencing. J Clin Microbiol 39:3147–3155PubMedCentralPubMedCrossRef
28.
Salata RA, Lerner PI, Shlaes DM, Gopalakrishna KV, Wolinsky E (1989) Infections due to Lancefield group C streptococci. Medicine (Baltimore) 68:225–239CrossRef
29.
30.
Rato MG, Nerlich A, Bergmann R et al (2011) Virulence gene pool detected in bovine group C Streptococcus dysgalactiae subsp. dysgalactiae isolates by use of a group A S. pyogenes virulence microarray. J Clin Microbiol 49:2470–2479PubMedCentralPubMedCrossRef
31.
32.
Ahmad Y, Gertz RE Jr, Li Z et al (2009) Genetic relationships deduced from emm and multilocus sequence typing of invasive Streptococcus dysgalactiae subsp. equisimilis and S. canis recovered from isolates collected in the United States. J Clin Microbiol 47:2046–2054PubMedCentralPubMedCrossRef
33.
McMillan DJ, Bessen DE, Pinho M et al (2010) Population genetics of Streptococcus dysgalactiae subspecies equisimilis reveals widely dispersed clones and extensive recombination. PLoS One 5:e11741PubMedCentralPubMedCrossRef
34.
35.
Horstmann RD, Sievertsen HJ, Knobloch J, Fischetti VA (1988) Antiphagocytic activity of streptococcal M protein: selective binding of complement control protein factor H. Proc Natl Acad Sci U S A 85:1657–1661PubMedCentralPubMedCrossRef
36.
37.
Kittang BR, Skrede S, Langeland N, Haanshuus CG, Mylvaganam H (2011) emm gene diversity, superantigen gene profiles and presence of SlaA among clinical isolates of group A, C and G streptococci from western Norway. Eur J Clin Microbiol Infect Dis 30:423–433PubMedCentralPubMedCrossRef
38.
O’Loughlin RE, Roberson A, Cieslak PR et al (2007) The epidemiology of invasive group A streptococcal infection and potential vaccine implications: United States, 2000–2004. Clin Infect Dis 45:853–862PubMedCrossRef
39.
Takahashi T, Ubukata K, Watanabe H (2011) Invasive infection caused by Streptococcus dysgalactiae subsp. equisimilis: characteristics of strains and clinical features. J Infect Chemother 17:1–10PubMedCrossRef
40.
Jensen A, Kilian M (2012) Delineation of Streptococcus dysgalactiae, its subspecies, and its clinical and phylogenetic relationship to Streptococcus pyogenes. J Clin Microbiol 50:113–126PubMedCentralPubMedCrossRef
41.
Sunaoshi K, Murayama SY, Adachi K et al (2010) Molecular emm genotyping and antibiotic susceptibility of Streptococcus dysgalactiae subsp. equisimilis isolated from invasive and non-invasive infections. J Med Microbiol 59:82–88PubMedCrossRef
42.
Kalia A, Enright MC, Spratt BG, Bessen DE (2001) Directional gene movement from human-pathogenic to commensal-like streptococci. Infect Immun 69:4858–4869PubMedCentralPubMedCrossRef
43.
Watanabe S, Kirikae T, Miyoshi-Akiyama T (2013) Complete genome sequence of Streptococcus dysgalactiae subsp. equisimilis 167 carrying Lancefield group C antigen and comparative genomics of S. dysgalactiae subsp. equisimilis strains. Genome Biol Evol 5:1644–1651PubMedCentralPubMedCrossRef
44.
Zhao J, Hayashi T, Saarinen S et al (2007) Cloning, expression, and characterization of the superantigen streptococcal pyrogenic exotoxin G from Streptococcus dysgalactiae. Infect Immun 75:1721–1729PubMedCentralPubMedCrossRef
45.
Tsai CT, Chi CY, Ho CM et al (2013) Correlation of virulence genes to clinical manifestations and outcome in patients with Streptococcus dysgalactiae subspecies equisimilis bacteremia. J Microbiol Immunol Infect. pii: S1684-1182(13)00164-3
46.
Ikebe T, Oguro Y, Ogata K et al (2010) Surveillance of severe invasive group G streptococcal infections in Japan during 2002–2008. Jpn J Infect Dis 63:372–375PubMed
47.
Pillai A, Thomas S, Williams C (2005) Clindamycin in the treatment of group G beta-haemolytic streptococcal infections. J Infect 51:e207–e211PubMedCrossRef
48.
Coyle EA, Cha R, Rybak MJ (2003) Influences of linezolid, penicillin, and clindamycin, alone and in combination, on streptococcal pyrogenic exotoxin a release. Antimicrob Agents Chemother 47:1752–1755PubMedCentralPubMedCrossRef
49.
Lam K, Bayer AS (1984) In vitro bactericidal synergy of gentamicin combined with penicillin G, vancomycin, or cefotaxime against group G streptococci. Antimicrob Agents Chemother 26:260–262PubMedCentralPubMedCrossRef
50.
Smyth EG, Pallett AP, Davidson RN (1988) Group G streptococcal endocarditis: two case reports, a review of the literature and recommendations for treatment. J Infect 16:169–176PubMedCrossRef
51.
Venezio FR, Gullberg RM, Westenfelder GO, Phair JP, Cook FV (1986) Group G streptococcal endocarditis and bacteremia. Am J Med 81:29–34PubMedCrossRef
52.
Gould FK, Denning DW, Elliott TS et al (2012) Guidelines for the diagnosis and antibiotic treatment of endocarditis in adults: a report of the Working Party of the British Society for Antimicrobial Chemotherapy. J Antimicrob Chemother 67:269–289PubMedCrossRef
53.
Kaul R, McGeer A, Norrby-Teglund A et al (1999) Intravenous immunoglobulin therapy for streptococcal toxic shock syndrome—a comparative observational study. The Canadian Streptococcal Study Group. Clin Infect Dis 28:800–807PubMedCrossRef
54.
Darenberg J, Ihendyane N, Sjölin J et al (2003) Intravenous immunoglobulin G therapy in streptococcal toxic shock syndrome: a European randomized, double-blind, placebo-controlled trial. Clin Infect Dis 37:333–340PubMedCrossRef
Metadata
Title
Streptococcus dysgalactiae subsp. equisimilis bacteremia: an emerging infection
Author
S. Rantala
Publication date
01-08-2014
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Clinical Microbiology & Infectious Diseases / Issue 8/2014
Print ISSN: 0934-9723
Electronic ISSN: 1435-4373
DOI
https://doi.org/10.1007/s10096-014-2092-0

Other articles of this Issue 8/2014

European Journal of Clinical Microbiology & Infectious Diseases 8/2014 Go to the issue

Article

Bone and joint infections due to anaerobic bacteria: an analysis of 61 cases and review of the literature

Review

Biology, systematics, and clinical manifestations of Zygomycota infections

Article

MALDI-TOF mass spectrometry as a tool for the discrimination of high-risk Escherichia coli clones from phylogenetic groups B2 (ST131) and D (ST69, ST405, ST393)

Article

Clinical evaluation of the Roche Elecsys® CMV IgG Avidity assay

Article

Comparison of flucytosine and fluconazole combined with amphotericin B for the treatment of HIV-associated cryptococcal meningitis: a systematic review and meta-analysis

Article

MicroRNA expressions associated with eosinophilic meningitis caused by Angiostrongylus cantonensis infection in a mouse model
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine
Image Credits