Pathogenesis, epidemiology and control of Group A Streptococcus infection
Stephan Brouwer,Tania Rivera-Hernandez,Bodie F. Curren,Nichaela Harbison-Price,David M. P. De Oliveira,Magnus G. Jespersen,Mark R. Davies,Mark Walker +7 more
TL;DR: The recent identification of clinical Group A Streptococcus pyogenes (GAS) isolates with reduced penicillin sensitivity and increasing macrolide resistance threatens both frontline and penicilin-adjunctive antibiotic treatment as mentioned in this paper .
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Abstract: Streptococcus pyogenes (Group A Streptococcus; GAS) is exquisitely adapted to the human host, resulting in asymptomatic infection, pharyngitis, pyoderma, scarlet fever or invasive diseases, with potential for triggering post-infection immune sequelae. GAS deploys a range of virulence determinants to allow colonization, dissemination within the host and transmission, disrupting both innate and adaptive immune responses to infection. Fluctuating global GAS epidemiology is characterized by the emergence of new GAS clones, often associated with the acquisition of new virulence or antimicrobial determinants that are better adapted to the infection niche or averting host immunity. The recent identification of clinical GAS isolates with reduced penicillin sensitivity and increasing macrolide resistance threatens both frontline and penicillin-adjunctive antibiotic treatment. The World Health Organization (WHO) has developed a GAS research and technology road map and has outlined preferred vaccine characteristics, stimulating renewed interest in the development of safe and effective GAS vaccines.
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Citations
Rapid expansion and international spread of M1UK in the post-pandemic UK upsurge of Streptococcus pyogenes
Yu Wan,Yan Ryan,Ho Kwong Li,Rebecca L Guy,Maria Papangeli,Kristin Krohn Huse,Lucy C Reeves,Valerie W C Soo,R. Daniel,Alessandra Harley,Karen Broughton,C. Dhami,Mark Ganner,Marjorie A Ganner,Zaynab Mumin,Maryam Razaei,Emma Rundberg,Rufat Mammadov,Ewurabena Mills,Vincenzo Sgro,Kai Yi Mok,Xavier Didelot,Nick Croucher,Elita Jauneikaite,Theresa Lamagni,Colin S Brown,Juliana Coelho,Shiranee Sriskandan +27 more
TL;DR: The UK witnessed a surge in invasive group A streptococcal infections in 2022, driven by the M1 UK lineage, which exhibits reduced genomic diversity and a fitness advantage in pathogenicity, allowing it to persist through population bottlenecks.
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Acute pharyngitis in children and adults: descriptive comparison of current recommendations from national and international guidelines and future perspectives.
Roberta Pellegrino,Edoardo Timitilli,Maria Carmen Verga,Alfredo Guarino,Iride Dello Iacono,Immacolata Scotese,Giovanna Tezza,Giulio Dinardo,Simona Riccio,Sofia Pellizzari,Sonia Iavarone,Giulia Lorenzetti,G Simeone,Marcello Bergamini,Daniele Donà,Luca Pierantoni,Silvia Garazzino,Susanna Esposito,Elisabetta Venturini,Guido Castelli Gattinara,Andrea Lo Vecchio,Gian Luigi Marseglia,Giuseppe Di Mauro,Nicola Principi,Luisa Galli,Elena Chiappini +25 more
TL;DR: Several divergencies in the management of acute pharyngitis were raised among guidelines (GLs) from different countries, both in the diagnostic and therapeutic approach, allowing the distinction of 3 different strategies.
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Global Streptococcus pyogenes strain diversity, disease associations, and implications for vaccine development: a systematic review
Pierre R. Smeesters,Gabrielle de Crombrugghe,Shu Ki Tsoi,Céline Leclercq,Ciara A Baker,Joshua Osowicki,Caroline Verhoeven,Anne Botteaux,Andrew C. Steer +8 more
TL;DR: The development of a truly global vaccine to reduce the immense burden of diseases caused by S pyogenes should consider the multidimensional diversity of the pathogen, including its social and environmental context, and not merely its geographical distribution.
18
Clinical and molecular epidemiological features of critically ill patients with invasive group A Streptococcus infections: a Belgian multicenter case-series
Marijke Peetermans,V. Matheeussen,Cedric Moerman,Fréderic De Rydt,Sabine Thieren,Emily Pollet,Michael P Casaer,Benjamin De Backer,Rudi De Paep,Yves Debaveye,Lars Desmet,Stefanie Desmet,Els I. M. Duval,Vincent Fraipont,Dieter Geysels,Greet Hermans,Frederik Lahaye,Xavier Mathy,Philippe Meersseman,Cécile Meex,Jozef Van Herck,Stefanie van Kleef-van Koeveringe,Nathalie Layios,Joost Wauters,Philippe G. Jorens +24 more
TL;DR: A Belgian multicenter study of 86 critically ill patients with invasive group A Streptococcus infections (2022-2023) found high incidence of severe community-acquired pneumonia, toxic shock syndrome, and mortality, with genomic analysis revealing a predominance of the toxigenic M1 UK lineage.
13
Metabolomics and network pharmacology reveal the mechanism of Castanopsis honey against Streptococcus pyogenes.
Wenjie Yu,Xiaohua Li,Qifang Sun,Shengxiang Yi,Gaowei Zhang,Lili Chen,Zhuozhen Li,Junru Li,Liping Luo +8 more
TL;DR: The results suggested that the activities of two antioxidant enzymes, glutathione peroxidase and tyrosyl tRNA synthetase identified as the primary targets, were significantly inhibited by CH, which significantly increased the level of oxidative stress in GAS.
11
References
Unexplained reduced microbiological efficacy of intramuscular benzathine penicillin G and of oral penicillin V in eradication of group a streptococci from children with acute pharyngitis.
TL;DR: Although these findings do not provide sufficient evidence to change current treatment recommendations or public health policy, important questions are raised about currently recommended penicillin doses, about the role of the carrier state, and possibly about adequate bioavailability of intramuscular BPG.