Non-pharyngeal infections due to Streptococcus dysgalactiae ssp. equisimilis in a tertiary hospital in Argentina over a period of 10 years.

Keywords: “Streptococcus dysgalactiae ssp. equisimilis”; “group G and C streptococci”; “β-hemolitic streptococci”; “Argentina”.

Abstract

Streptococcus dysgalactiae ssp. equisimilis (SDSE) is a β-hemolytic streptococcus that colonizes the skin and mucous membranes of humans. According to the Lancefield classification, most of them present the C or G antigens and rarely the A antigen. In recent years, an increase in infections caused by  this microorganism has been reported, mainly in elderly people or those with chronic diseases.

In this review, non-pharyngeal infections caused by SDSE are described in patients admitted to a tertiary hospital in Argentina between 2013 and 2023. Twelve infections were documented; 58% (7/12) of the patients were male and 42% (5/12) were female; the median (range) age was 63 (9-87) years. Ten (83%) patients presented invasive infections; 5 (42%) with the presence of bacteremia. Eleven (92%) patients had at least one underlying disease and all had at least one risk factor associated with infection. All patients received treatment with a β-lactam antibiotic. In 2 cases of soft tissue cellulitis the association with clindamycin and surgical debridement in one of them  was necessary to resolve the infection. Overall mortality was 8.3% (1/12 patients).

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Author Biographies

Patricia Olga Andres

Microbiología, Laboratorio Central, Hospital Universitario Fundación Favaloro.

María Selene Aballay

Microbiología, Laboratorio Central, Hospital Universitario Fundación Favaloro.

Bárbara Aristimuño

Microbiología, Laboratorio Central, Hospital Universitario Fundación Favaloro.

Paula Caucia

Microbiología, Laboratorio Central, Hospital Universitario Fundación Favaloro.

Fabián Malacasa

Microbiología, Laboratorio Central, Hospital Universitario Fundación Favaloro.

Alejandra Valledor

Epidemiología e Infectología Clínica, Hospital Universitario Fundación Favaloro.

Analía Laura Fernández

Microbiología, Laboratorio Central, Hospital Universitario Fundación Favaloro.

References

Referencias bibliográficas:
1. Takahashi T, Ubukata K. Invasive infection caused by Streptococcus dysgalactiae subsp. equisimilis: characteristics of strains and clinical features. J Infect Chemother 2011, 17:1-10.
2. Rantala S. Streptococcus dysgalactiae subsp. equisimilis bacteremia: an emerging infection. Eur J Clin Microbiol Infect Dis 2014, 33(8)1303-1310.
3. Hikone M, Nagai K, Inoue K, Noji S, Sugiyama K, Hamabe Y. Invasive infection due to Streptococcus dysgalactiae subspecies equisimilis causing endocraditis and ventriculitis: a case report. Clin Case Rep 2021, 9(9):e04638.
4. Iwasaki K, Okino R, Okazaki A, Kawashiri A. Streptococcal toxic shock síndrome caused by Streptococcus dysgalactiae subsp. equisimilis-related empiema: a novel case report. Intern Med 2024, 63(7):1021-1025.
5. Baracco GJ. Infections caused by group C and G streptococcus (Streptococcus dysgalactiae subsp. equisimilis and others): epidemiological and clinical aspects. Microbiol Spectr 2019, 7(2). GPP3-0016-2018.
6. Bonofiglio L, Gagetti P, García Gabarrot G, Kaufman S, Mollerach M, Toresani I y col. Susceptibility to βlactams in β-hemolytic streptococci. Rev Argent Microbiol 2018, 50(4):431-435.
7. Lopardo H, Vidal P, Sparo M, Jeric P, Centrón D, Facklam RR y col. Six-month multicenter study on invasive infections due to Streptococcus pyogenes and Streptococcus dysgalactiae subsp. equisimilis in Argentina. J Clin Microbiol 2005, 43(2):802-807.
8. Traverso F, Blanco A, Villalón P, Beratz N, Sáez Nieto JA, Lopardo H y col. Molecular characterization of invasive Streptococcus dysgalactiae subsp. equisimilis. Multicenter study: Argenitina 2011-2012. Rev Argent Microbiol 2016, 48(4):279-289.
9. Documento de la Sociedad Argentina de Infectología sobre Streptococcus pyogenes, 28 de julio de 2023. Disponible en https://doc-14-3s-prod-02-apps-viewer.googleusercontent.com/viewer2/prod-02/pdf/tijr3fkphpaituvt589k0jte2n1tuqg7/ii458j4rkbb0os2s3i3egdojhjn8l05u/1720703475000/3/*/APznzaaIv81YxZg6h0z_Y3iJYV_XfBy6WdmO273vYMhcmzPrDBrfvzvFMXmXaLgHuarIIdkAieLESFFuLM_k_N8aQ9uXQAgLvpxXVKbl3FHfsRgpX_GHy9Fkp4fucl5hCt-WP5br37Hovwd3hFnQ5eJ-eWTY2siG4oaiKPdAFsQZkk-x303ulLceJIeTKOHs7E_qAG_LM8MhNsFSee4eUIxFe2YxYEClOOAr02R2f5TYtSv6TybkwTUFd8Sm6_jqQASDXW_Cw-1NOmKJr8ONQBGCQNPUvTL42hOyTLycmQdgc-Qpb6xZK22kXpRdUue7etV6D_5pK7q53-K2mn5eYbmLNYe5i5TwDgkRss_QgbgG9l6Jo608OwkrLZ81YGHGN5AVEFFXRhe3Xrgm6YcDKF530w-vgzBlAQ==?authuser
10. Clinical and Laboratory Standards Institute (CLSI). Performance Standards for Antimicrobial Susceptibility Testing, 34th ed.; CLSI Supplement M100; Clinical and Laboratory Standards Institute: Wayne, PA, USA, 2024.
11. Nevanlinna V, Huttunen R, Aittoniemi J, Luukkaala T, Rantala S. Incidence, seasonal pattern, and clinical manifestations of Streptococcus dysgalactiae subspecies equisimilis bacteremia; a population-based study. Eur J Clin Microbiol Infect Dis 2023, 42:819-825.
12. Oppegaard O, Glambek M, Skutlaberg DH, Skrede S, Sivertsen A, Kittang BR. Strpetococcus dysgalactiae bloodstream infections, Norway, 1999-2021. Emerg Infect Dis 2023, 29(2):260-267.
13. Rojo-Bezares B, Toca L, Azcona-Gutiérrez JM, Ortega-Unanue N, Toledano P, Sáenz Y. Streptococcus dysgalactiae subsp. equisimilis from invasive an non-invasive infections in Spain: combining epidemiology, molecular characterization, and genetic diversity. Eur J Clin Microbiol Infect Dis 2021, 40(5):1013-1021.
14. Cunto E, Colque AM, Herrera MP, Chediack V, Staneloni MI, Saúl PA. Infecciones graves de piel y partes blandas. Puesta al día. Medicina (B Aires) 2020, 80:531-540.
15. OMS: Aumento de la incidencia de la escarlatina y de infecciones invasivas por estreptococos del grupo A en varios países. Disponible en https://www.who.int/es/emergencies/diseaseoutbreak-news/item/2022- DON429#:~:text=A%20lo%20largo%20de%202022,ni%C3%B1os%20menores%20de%2010 %20a%C3%B1os.
16. Organización Panamericana de la Salud, Nota Informativa: Casos de enfermedades causadas por estreptococo del grupo A en Uruguay. 19 de diciembre de 2022. Disponible en https://www.paho.org/es/documentos/nota-informativa-casos-enfermedades-causadaspor-estreptococo-grupo-uruguay
17. CDC: Increase in Pediatric Invasive Group A Streptococcal Infection. Disponible en https://emergency.cdc.gov/han/2022/han00484.asp
18. Boletín Epidemiológico Nacional N°679, SE 46, Año 2023. Ministerio de Salud, Argentina. ISSN: 2422-698X (en línea); ISSN: 2422-6998 (correo electrónico).
19. Instructivo para la notificación de S. pyogenes en el SNVS – Julio 2023. Dirección de Epidemiología, Ministerio de Salud, Argentina.
Published
2024-10-31
How to Cite
Andres, P. O., Aballay, M. S., Aristimuño, B., Caucia, P., Malacasa, F., Valledor, A., & Fernández, A. L. (2024). Non-pharyngeal infections due to Streptococcus dysgalactiae ssp. equisimilis in a tertiary hospital in Argentina over a period of 10 years. Actualizaciones En Sida E Infectología, 32(116). https://doi.org/10.52226/revista.v32i116.336
Section
Brief communication