Clinical and microbiological characteristics of severe Streptococcus pyogenes disease in Europe.

In an attempt to compare the epidemiology of severe Streptococcus pyogenes infection within Europe, prospective data were collected through the Strep-EURO program. Surveillance for severe cases of S. pyogenes infection diagnosed during 2003 and 2004 was undertaken in 11 countries across Europe by using a standardized case definition and questionnaire.

Molecular characterization of clinical isolates of M non-typable group A streptococci from invasive disease cases.

Currently there are 93 validated M serotypes of Streptococcus pyogenes, Lancefield group A streptococcus (GAS), and >130 emm genotypes. A marked increase in the number of non-typable GAS isolates (2 % in 2000, 4 % in 2001 and 9 % in 2002) from invasive disease cases referred to the authors' reference laboratory was noted during 2000-2002. A total of 217 (92 %) were from blood cultures, 14 (6 %) from deep abscesses and five (2 %) from aspirates.

Increasing incidence of group A streptococcal infections amongst injecting drug users in England and Wales.

During 2000, the UK witnessed a sudden increase in severe infections and related deaths in injecting drug users (IDUs), sparking off a UK-wide investigation. A worrying upward trend in severe group A streptococcal (GAS) infections has recently been observed in IDUs based upon isolate referrals to the PHLS Respiratory and Systemic Infection Laboratory. Most cases were young male adults who presented with skin sepsis and bacteraemia.

Extensive genetic diversity among clinical isolates of Streptococcus pyogenes serotype M5.

The genetic diversity of clinical isolates of Streptococcus pyogenes serotype M5 has been characterized. Strain genotypes were defined by macrorestriction profile, 16S ribotype, emm gene subtype, insertion element IS1239 profile, and exotoxin gene determinant. By these criteria, clinical isolates of M5 constituted a multiplicity of strain clusters rather than a homogeneous population as found for certain serotypes.