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首页> 外文期刊>感染症学雑誌 >Epidemiological study on Streptococcus pyogenes strains isolated from the patients with streptococcal toxic shock syndrome (STSS) in Japan in 1992-2001
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Epidemiological study on Streptococcus pyogenes strains isolated from the patients with streptococcal toxic shock syndrome (STSS) in Japan in 1992-2001

机译：1992-2001年日本分离自化脓性链球菌中毒性休克综合征（STSS）患者的化脓性链球菌菌株的流行病学研究

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摘要

To investigate clinical and microbiological features of streptococcal toxic shock syndrome (STSS), clinical, epidemiological, and bacteriological data obtained from 250 patients between 1992 and 2001 were analyzed. Among these 250 cases, 16 cases were excluded from the study because the causative microorganism were not Streptococcus pyogenes. 234 strains of S. pyogenes obtained from the aforementioned 234 cases were tested for T-type by a serological method, and for streptococcal pyrogenic exotoxin (SPE) by in vitro productivity of the toxin as well as molecular genetic methods. The number of patients was 141 (56.4%) for males, and 107 (42.8%) for females. The highest frequency of STSS was observed in those patients in their sixties in both sexes. The overall mortality rate was 43.2%. The mortality rate for male was 36.9%, and 52.3% for female. Bacteriological studies revealed that most common T types were T1 and T3. These strains consisted 54.3% of the strains collected. Among strains of T1 type, 98.8% possessed genes of spe A, and 46.1% were shown to produce SPE A in vitro. Among strains of T3 type, 82.9% possessed spe A gene, and all of these strains were shown to produce the toxin in vitro. It is concluded that certain strains of S. pyogenes, such as those with T1, or T3 type, and those with spe A gene or in vitro production of SPE A, are the most frequent cause of STSS. Although infections caused by such bacteria are quite common, STSS rarely occurs in most such patients. Additional factors, such as host factors, may play a crucial role in the pathogenesis of STSS.
机译：为了调查链球菌中毒性休克综合征（STSS）的临床和微生物学特征，分析了1992年至2001年间250例患者的临床，流行病学和细菌学数据。在这250例病例中，有16例被排除在研究之外，因为病原微生物不是化脓链球菌。通过血清学方法测试了从上述234例病例中获得的234株化脓性链球菌的T型，并通过毒素的体外生产率以及分子遗传学方法测试了链球菌热原性外毒素（SPE）。男性患者为141位（56.4％），女性为107位（42.8％）。六十多岁的男女患者中STSS的发生频率最高。总死亡率为43.2％。男性死亡率为36.9％，女性为52.3％。细菌学研究表明，最常见的T型是T1和T3。这些菌株占所收集菌株的54.3％。在T1型菌株中，有98.8％拥有spe A基因，并且有46.1％具有体外产生SPE A的能力。在T3型菌株中，有82.9％的菌株具有spe A基因，并且所有这些菌株均在体外产生毒素。结论是化脓性链球菌的某些菌株，例如具有T1或T3型的那些，以及具有spe A基因或体外产生的SPE A的菌株，是STSS的最常见原因。尽管由此类细菌引起的感染非常普遍，但在大多数此类患者中很少发生STSS。其他因素，例如宿主因素，可能在STSS的发病机理中起关键作用。

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