Charles Darwin University

CDU eSpace
Institutional Repository

 
CDU Staff and Student only
 

Streptococcal necrotising fasciitis from diverse strains of Streptococcus pyogenes in tropical northern Australia: case series and comparison with the literature

Hassell, Marilyn, Fagan, Peter, Carson, Phillip and Currie, Bart J. (2004). Streptococcal necrotising fasciitis from diverse strains of Streptococcus pyogenes in tropical northern Australia: case series and comparison with the literature. BMC Infectious Diseases,4:60-67.

Document type: Journal Article
Citation counts:
Google Scholar Search Google Scholar
Attached Files (Some files may be inaccessible until you login with your CDU eSpace credentials)
Name Description MIMEType Size Downloads
Read with bookreader Download this reading  Hassell_24336.pdf Published version application/pdf 301.98KB 31
Reading the attached file works best in Firefox, Chrome and IE 9 or later.

Title Streptococcal necrotising fasciitis from diverse strains of Streptococcus pyogenes in tropical northern Australia: case series and comparison with the literature
Author Hassell, Marilyn
Fagan, Peter
Carson, Phillip
Currie, Bart J.
Journal Name BMC Infectious Diseases
Publication Date 2004
Volume Number 4
ISSN 1471-2334   (check CDU catalogue open catalogue search in new window)
Start Page 60
End Page 67
Total Pages 8
Place of Publication United Kingdom
Publisher BioMed Central Ltd.
Abstract Background: Since the mid-1980's there has been a worldwide resurgence of severe disease from group A streptococcus (GAS), with clonal clusters implicated in Europe and the United States. However GAS associated sepsis and rheumatic fever have always remained at high levels in many less developed countries. In this context we aimed to study GAS necrotising fasciitis (NF) in a region where there are high background rates of GAS carriage and disease.

Methods: We describe the epidemiology, clinical and laboratory features of 14 consecutive cases of GAS NF treated over a seven year period from tropical northern Australia.

Results: Incidence rates of GAS NF in the Aboriginal population were up to five times those previously published from other countries. Clinical features were similar to those described elsewhere, with 7/14 (50%) bacteremic and 9/14 (64%) having associated streptococcal toxic shock syndrome. 11/14 (79%) had underlying chronic illnesses, including all four fatalities (29% mortality overall). Important laboratory differences from other series were that leukocytosis was absent in 9/14 (64%) but all had substantial lymphopenia. Sequence typing of the 14 NF-associated GAS isolates showed no clonality, with only one emm type 1 and two emm type 3 strains.

Conclusions: While NF clusters can occur from a single emergent GAS clone, this was not evident in our tropical region, where high rates of NF parallel high overall rates of GAS infection from a wide diversity of strains. The specific virulence factors of GAS strains which do cause NF and the basis of the inadequate host response in those patients who develop NF on infection with these GAS require further elucidation.
Keywords GAS necrotising fasciitis (NF)
Streptococcus pyogenes
tropical northern Australia
group A streptococcus (GAS)
DOI http://dx.doi.org/10.1186/1471-2334-4-60   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)


© copyright

Every reasonable effort has been made to ensure that permission has been obtained for items included in CDU eSpace. If you believe that your rights have been infringed by this repository, please contact digitisation@cdu.edu.au.

 
Versions
Version Filter Type
Access Statistics: 32 Abstract Views, 37 File Downloads  -  Detailed Statistics
Created: Fri, 19 Oct 2012, 15:45:35 CST by Teresa Haendel