A Review article of Streptococcus pyogenes Infection: Rick factors, Prevention and Management Strategies

Authors

  • Maryam A. Ali Department of Microbiology, College of Medicine, University of Baghdad, Baghdad, Iraq
  • Shaimaa J Kadhim Department of Microbiology, College of Medicine, University of Baghdad, Baghdad, Iraq
  • Yasmeen J. Al-Bayaa Department of Microbiology, College of Medicine, University of Baghdad, Baghdad, Iraq

DOI:

https://doi.org/10.32007/jfacmedbagdad.6512041

Keywords:

Prevention, Infections, Management strategies, Streptococcus pyogenes

Abstract

Background: Streptococcus pyogenes is an exclusively human pathogen. This bacterial species is responsible for a large variety of infections.

Objective: This review identified published articles on the risk factors, prevention, and control strategies for Streptococcus diseases.

Material and methods: A systematic search was carried out to identify papers published on the Web of Science, PubMed, Scopus, and Google Scholar electronic databases in an attempt to provide basic information about Streptococcus infections, potential risks for their spread, and treatment and prevention strategies.

Results: The more common methods for Streptococcus pyogenes transmission are through respiratory droplets or skin lesions brought on by Streptococcus pyogenes contact with infected objects or devices. Another potential mode is foodborne transmission, but more research is needed to determine this infection route. Native communities and those of low socio-economic status worldwide were found particularly susceptible to Streptococcus diseases, as well as children, older adults, and those with impaired immune systems. Those groups are susceptible to Streptococcus pyogenes infections and their complications, with higher infectious rates in educational institutions, hospitals, overcrowding, and the continuous increase in social contact. The importance of improving living conditions and personal and hand hygiene is one of the techniques in the management and prevention of Streptococcus pyogenes infections. Infection control methods must be highlighted with greater precision.

Conclusion: Prevention and control measures should target the improvement of living conditions, and personal and hand hygiene. Adherence to infection prevention and control practices should be emphasized in high-risk settings.

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References

Kimberlin DW, Brady MT, Jackson MA. Group A Streptococcal Infections; American Academy of Pediatrics: Itasca, IL, USA, 2015; pp. 732-744. https://doi.org/10.1542/9781581109276-Group

World Health Organization. The Current Evidence for the Burden of Group A Streptococcal Diseases; World Health Organization: Geneva, Switzerland, 2005.

Ralph AP, Carapetis JR. Group A streptococcal diseases and their global burden. In Host-Pathogen Interactions in Streptococcal Diseases; Springer: Berlin/Heidelberg, Germany, 2012; pp. 1-27 https://doi.org/10.1007/82_2012_280

Nabat Z N, Alateef BA. and Hussain IM. Bacteriological and Immunological Study of Patients with Tonsillitis in Hila City. Iraqi Journal of Biotechnology.(2019) 18(2): 252-260. https://www.jige.uobaghdad.edu.iq/index.php/IJB/article/view/357/273

You Y, Davies MR, Protani M, McIntyre L, Walker MJ, Zhang J. Scarlet fever epidemic in China caused by Streptococcus pyogenes serotype M12: Epidemiologic and molecular analysis. EBioMedicine 2018, 28, 128-135. https://doi.org/10.1016/j.ebiom.2018.01.010

Tagini F, Aubert B, Troillet N, Pillonel T, Praz G, Crisinel P, et al. Importance of whole genome sequencing for the assessment of outbreaks in diagnostic laboratories: Analysis of a case series of invasive Streptococcus pyogenes infections. Eur. J. Clin. Microbiol. Infect. Dis. 2017, 36, 1173-1180. https://doi.org/10.1007/s10096-017-2905-z

Zhang Q, Liu W, Ma W, Shi Y, Wu Y, Li Y, et al. Spatiotemporal epidemiology of scarlet fever in Jiangsu Province, China, 2005-2015. BMC Infect. Dis. 2017, 17, 596. https://doi.org/10.1186/s12879-017-2681-5

Nelson GE, Pondo T, Toews KA, Farley MM, Lindegren ML, Lynfield R, et al. Epidemiology of invasive group A streptococcal infections in the United States, 2005-2012. Rev. Infect. Dis. 2016, 63, 478-486. https://doi.org/10.1093/cid/ciw248

Mosites E, Frick A, Gounder P, Castrodale L, Li Y, Rudolph K, et al. Outbreak of invasive infections from subtype emm26. 3 group A streptococcus among homeless adults-Anchorage, Alaska, 2016-2017. Clin. Infect. Dis. 2018, 66, 1068 1074.https://doi.org/10.1093/cid/cix921

Fahad HM. Types of Aerobic Bacteria Isolated from Iraqi Patients with Acute Tonsillitis and their Susceptibility to Different Antibiotics. J. Pure Appl. Microbiol. 12(4): 1-5.

Tyrrell GJ, Fathima S, Kakulphimp J, Bell C. Increasing rates of invasive group A streptococcal disease in Alberta, Canada; 2003-2017. In Open Forum Infectious Diseases; Oxford University Press: New York, NY, USA, 2018; p. ofy177. https://doi.org/10.1093/ofid/ofy177

Mahdi AZ, Hassan JH and Jebur KS. Antibiotic Susceptibility of Streptococcus pyogenes Isolated from Otitis Media and Tonsillitis among Children Patients. Int.J.Curr.Microbiol.App.Sci. 2017 : 6(8): 998-1004. https://doi.org/10.20546/ijcmas.2017.608.123

Watts V, Balasegaram S, Brown CS, Mathew S, Mearkle R, Ready D, et al. Increased risk for invasive group A streptococcus disease for household contacts of scarlet fever cases, England, 2011-2016. Emerg. Infect. Dis. 2019, 25, 529. https://doi.org/10.3201/eid2503.181518.

Barnett T, Bowen A, Carapetis JR The fall and rise of group A streptococcus diseases. Epidemiol. Infect. 2019, 147, e4. https://doi.org/10.1017/S0950268818002285

Al-Shwany ZH, Al-Jebori IS. Molecular study of sortase enzyme in Streptococcus pyogenes isolated from patients with tonsillitis in Kirkuk city. Kirkuk J. Sci. 2015;10(2). https://doi.org/10.32894/kujss.2015.103487

Carapetis JR, Steer AC, Mulholland EK, Weber M. The global burden of group A streptococcal diseases. Lancet Infect. Dis. 2005, 5, 685-694. https://doi.org/10.1016/S1473-3099(05)70267-X.

Nanduri S, Metcalf B, Arwady M, Edens C, Lavin M, Morgan J, et al. Prolonged and large outbreak of invasive group A Streptococcus disease within a nursing home: Repeated intrafacility transmission of a single strain. Clin. Microbiol. Infect. 2019, 25, 248.e1-248.e7. https://doi.org/10.1016/j.cmi.2018.04.034

May PJ, Bowen AC, Carapetis JR. The inequitable burden of group A streptococcal disease in Indigenous Australians. Med. J. Aust. 2016, 205, 201-203. https://doi.org/10.5694/mja16.00400

Chen M, Wang W, Tu L, Zheng Y, Pan H, Wang G, et al. An emm5 group A streptococcal outbreak among workers in a factory manufacturing telephone accessories. Front. Microbiol. 2017, 8, 1156. https://doi.org/10.3389/fmicb.2017.01156

Shakoor S, Khan E, Mir F, Malik F, Jamil B. Secular trends of Streptococcus pyogenes sepsis in Pakistan and analysis of clinical features in a hospitalized cohort. Trop. Biomed. 2017, 34, 648-656.

Oliver JR, Pierse N, Stefanogiannis N, Jackson C, Baker MG. Acute rheumatic fever and exposure to poor housing conditions in New Zealand: A descriptive study. Paediatr. Child Health 2017, 53, 358-364. https://doi.org/10.1111/jpc.13421

Athey TB, Teatero S, Sieswerda LE, Gubbay JB, Marchand-Austin A, Li A, et al. High incidence of invasive group A Streptococcus disease caused by strains of uncommon emm types in Thunder Bay, Ontario, Canada. J. Clin. Microbiol. 2016, 54, 83-92. https://doi.org/10.1128/JCM.02201-15.

Cannon J, Abouzeid M, de Klerk N, Dibben C, Carapetis J, Katzenellenbogen J. Environmental and social determinants of acute rheumatic fever: A longitudinal cohort study. Epidemiol. Infect. 2019, 147. https://doi.org/10.1017/S0950268818003527.

Saavedra-Campos M, Simone B, Balasegaram S, Wright A, Usdin M, Lamagni T. Estimating the risk of invasive group A streptococcus infection in care home residents in England, 2009-2010. Epidemiol. Infect. 2017, 145, 2759-2765. https://doi.org/10.1017/S0950268817001674

Dickinson H, Reacher M, Nazareth B, Eagle H, Fowler D, Underwood A, et al. Whole-genome sequencing in the investigation of recurrent invasive group A streptococcus outbreaks in a maternity unit. J. Hosp. Infect. 2019, 101, 320-326. https://doi.org/10.1016/j.jhin.2018.03.018

Liu Y, Chan TC, Yap LW, Luo Y, Xu W, Qin S, et al. Resurgence of scarlet fever in China: A 13-year population-based surveillance study. Lancet Infect. Dis. 2018, 18, 903-912. https://doi.org/10.1016/S1473-3099(18)30231-7

Abidali, ZN,. Immunological and molecular study of the bacteria that cause Tonsillitis. Master thesis. College of Science for Girls Babylon University, Iraq.(2014)

Lee CF, Cowling BJ, Lau EH. Epidemiology of reemerging scarlet fever, Hong Kong, 2005-2015. Emerg. Infect. Dis. 2017, 23, 1707. https://doi.org/10.3201/eid2310.161456

Chalker VJ, Smith A, Al-Shahib A, Botchway S, Macdonald E, Daniel R, et al. Integration of genomic and other epidemiologic data to investigate and control a cross-institutional outbreak of Streptococcus pyogenes. Emerg. Infect. Dis. 2016, 22, 973. https://doi.org/10.3201/eid2204.142050

Dohoo C, Stuart R, Finkelstein M, Bradley K, Gournis E. Risk factors associated with group A streptococcus acquisition in a large, urban homeless shelter outbreak. Can. J. Public Health 2020, 111, 117-124. https://doi.org/10.17269/s41997-019-00258-5 31.

Worthing 31. KA, Werno A, Pink R, McIntyre L, Carter GP, Williamson DA, et al. Biphasic outbreak of invasive group A Streptococcus disease in elder care facility, New Zealand. Emerg. Infect. Dis. 2020, 26, 841. https://doi.org/10.3201/eid2605.190131

Hammond-Collins K, Strauss B, Barnes K, Demczuk W, Domingo MC, Lamontagne MC, et al. Group A streptococcus outbreak in a Canadian armed forces training facility. Mil. Med. 2019, 184, e197-e204. [CrossRef] [PubMed]

https://doi.org/10.1093/milmed/usy198

Teatero S, McGeer A, Tyrrell GJ, Hoang L, Smadi H, Domingo MC, et al. Canada-wide epidemic of emm74 group A streptococcus invasive disease. In Open Forum Infectious Diseases; Oxford University Press: New York, NY, USA, 2018; p. ofy085. https://doi.org/10.1093/ofid/ofy085

Cannon J, Abouzeid M, de Klerk N, Dibben C, Carapetis J, Katzenellenbogen J. Environmental and social determinants of acute rheumatic fever: A longitudinal cohort study. Epidemiol. Infect. 2019, 147. https://doi.org/10.1017/S0950268818003527

Adebanjo T, Mosites E, Van Beneden CA, Onukwube J, Blum M, Harper M, et al. Risk factors for group A streptococcus colonization during an outbreak among people experiencing homelessness in Anchorage, Alaska, 2017. Clin. Infect. Dis. 2018, 67, 1784-1787. https://doi.org/10.1093/cid/ciy429

Bennett J, Moreland NJ, Oliver J, Crane J, Williamson DA, Sika-Paotonu D, et al. Understanding group A streptococcal pharyngitis and skin infections as causes of rheumatic fever: Protocol for a prospective disease incidence study. BMC Infect. Dis. 2019, 19, 633. https://doi.org/10.1186/s12879-019-4126-9

Chadha A, Jamal W, Aziz AR, Rotimi VO. Overwhelming Streptococcus pyogenes sepsis in an elderly patient with septic arthritis. J. Infect. Public Health 2018, 11, 434-435. https://doi.org/10.1016/j.jiph.2017.08.011

Dakhil BR and Hamim SS. Antibiotic susceptibility of Streptococcus pyogenes and Staphylococcus aureus isolated from Pharyngitis and Tonsillitis patients in Nasiriyah City, Iraq. World J Pharm Sci 2016; 4(4): 14-19.

Francis JR, Gargan C, Remenyi B, Ralph AP, Draper A, Holt D, et al. A cluster of acute rheumatic fever cases among Aboriginal Australians in a remote community with high baseline incidence. Aust. N. Z. J. Public Health 2019, 43, 288-293. https://doi.org/10.1111/1753-6405.12893

Cohen R, Cohen S, Afraimov M, Finn T, Babushkin F, Geller K, et al. Screening asymptomatic households for Streptococcus pyogenes pharyngeal carriage as a part of in-hospital investigation of puerperal sepsis. Am. J. Infect. Control 2019, 47, 1493-1499. https://doi.org/10.1016/j.ajic.2019.05.029

Riad M, Thottacherry E, Crawley C, Phillip-Abraham N, Ibrahim F. Invasive Group A streptococcal postpartum endometritis associated with multi-organ infarctions: An uncommon case presentation and literature review. Postgrad. Med. 2020, 132, 526-531. https://doi.org/10.1080/00325481.2020.1760031

Alexander AJ, Myers C, Beres SB, Olsen RJ, Musser JM, Mangino JE. Postpartum group A streptococcus case series: Reach out to infection prevention! Open Forum Infect. Dis. 2018, 5, ofy159. https://doi.org/10.1093/ofid/ofy159

Seale AC, Davies MR, Anampiu K, Morpeth SC, Nyongesa S, Mwarumba S, et al. Invasive group A streptococcus infection among children, rural Kenya. Emerg. Infect. Dis. 2016, 22, 224. https://doi.org/10.3201/eid2202.151358

Bundle N, Bubba L, Coelho J, Kwiatkowska R, Cloke R, King S, et al. Ongoing outbreak of invasive and non-invasive disease due to group A streptococcus (GAS) type emm66 among homeless and people who inject drugs in England and Wales, January to December 2016. Eurosurveillance 2017, 22, 30446. https://doi.org/10.2807/1560-7917.ES.2017.22.3.30446

Sharma H, Ong M, Ready D, Coelho J, Groves N, Chalker V, et al. Real-time whole genome sequencing to control a Streptococcus pyogenes outbreak at a national orthopaedic hospital. J. Hosp. Infect. 2019, 103, 21-26. https://doi.org/10.1016/j.jhin.2019.07.003

Kobayashi M, Lyman MM, Francois Watkins LK, Toews KA, Bullard L, Radcliffe RA, et al. A cluster of group A streptococcal infections in a skilled nursing facility—the potential role of healthcare worker presenteeism. J. Am. Geriatr. Soc. 2016, 64, e279-e284.https://doi.org/10.1111/jgs.14505

Oliver J, Thielemans E, McMinn A, Baker C, Britton PN, Clark JE, et al. Invasive group A Streptococcus disease in Australian children: 2016 to 2018-a descriptive cohort study. BMC Public Health 2019, 19, 1-10. https://doi.org/10.1186/s12889-019-8085-2

Oliver J, Wilmot M, Strachan J, St George S, Lane CR, Ballard SA, et al. Recent trends in invasive group A Streptococcus disease in Victoria. Commun. Dis. Intell. Q. Rep. 2019, 2018, 43. https://doi.org/10.33321/cdi.2019.43.8

Ralph AP, Holt DC, Islam S, Osowicki J, Carroll DE, Tong SY, et al. Potential for molecular testing for group A streptococcus to improve diagnosis and management in a high-risk population: A prospective study. In Open Forum Infectious Diseases; Oxford University Press: New York, NY, USA, 2018; p. ofz097. https://doi.org/10.1093/ofid/ofz097

Barth D, Naicker P, Engel K, Muhamed B, Basera W, Mayosi, et al. Molecular epidemiology of noninvasive and invasive group A streptococcal infections in Cape Town. mSphere 2019, 4. https://doi.org/10.1128/mSphere.00907-19

Olp RJ, Chamales IA, Schmiedecke SS. A case study of puerperal Group A Streptococcal infection complicated by toxic shock syndrome. Am. J. Perinatol. Rep. 2020, 10, e1. https://doi.org/10.1055/s-0039-1697648

Baker MG, Gurney J, Oliver J, Moreland NJ, Williamson DA, Pierse N, et al. Risk factors for acute rheumatic fever: Literature review and protocol for a case-control study in New Zealand. Int. J. Environ. Res. Public Health 2019, 16, 4515.https://doi.org/10.3390/ijerph16224515

Mathan JJ, Erkart J, Houlding A. Clinical management and patient persistence with antibiotic course in suspected group A streptococcal pharyngitis for primary prevention of rheumatic fever: The perspective from a New Zealand emergency department. N. Z. Med. J. 2017, 130, 58-68.

Centers for Disease Control and Prevention. Group A Streptococcal (GAS) Disease; U.S. Department of Health and Human Services: Atlanta, GE, USA, 2020.

Faihan WA and Darweesh MF. The Impact of IL-6 serum level on Tonsillitis and Tonsillectomy Patients infected with Streptococeus pyogenes. Journal of Physics: Conference Scric, 1660(2020) 012019. https://doi.org/10.1088/1742-6596/1660/1/012019.

Chen, M.; Wang, W.; Tu, L.; Zheng, Y.; Pan, H.; Wang, G.; Chen, Y.; Zhang, X.; Zhu, L.; Chen, J. An emm5 group A streptococcal outbreak among workers in a factory manufacturing telephone accessories. Front. Microbiol. 2017, 8, 1156.

https://doi.org/10.3389/fmicb.2017.01156

Sosa MEB. Group A streptococcal infection in pregnancy and the puerperium. J. Perinat. Neonatal Nurs. 2016, 30, 124-130. https://doi.org/10.1097/JPN.0000000000000166

International Commission on Microbiological Specifications for Foods. Microorganisms in Foods 5: Characteristics of Microbial Pathogens; Springer Science and Business Media: Berlin/ Heidelberg, Germany, 1996; Volume 5.

Okuzono S, Ishimura M, Kanno S, Sonoda M, Kaku N, Motomura Y, et al. Streptococcus pyogenes-Purpura fulminans as an invasive form of group A streptococcal infection. Ann. Clin. Microbiol. Antimicrob. 2018, 17, 31. https://doi.org/10.1186/s12941-018-0282-9.

Mahida N, Prescott K, Yates C, Spencer F, Weston V, Boswell T. Outbreak of invasive group A streptococcus: Investigations using agar settle plates detect perineal shedding from a healthcare worker. J. Hosp. Infect. 2018, 100, e209-e215. https://doi.org/10.1016/j.jhin.2018.03.029

Lanitis S, Khan M, Sgourakis G, Kontovounisios C, Papaconstandinou T, Karaliotas C. Severe monobacterial necrotizing soft tissue infection by group A streptococcus: A surgical emergency. Asian Pac. J. Trop. Biomed. 2012, 2, 250-252. https://doi.org/10.1016/S2221-1691(12)60052-5

Kawaguchi K, Mori N, Ejima T, Yamada Y, Takahashi T. Streptococcal toxic shock syndrome following group A streptococcal vulvovaginitis in a breastfeeding woman. J. Infect. Chemother. 2019, 25, 1037-1039. https://doi.org/10.1016/j.jiac.2019.05.001

Al-Aawadi KK Antibiotic Profile and Molecular Characterization of Staphylococcus aureus Isolated from Tonsillitis Patients at Thi-Qar Province. Master thesis. College of Sciences Thi-Qar University, Iraq.2014

Rottenstreich A, Benenson S, Levin G, Kleinstern G, Moses A, Amit S. Risk factors, clinical course and outcomes of pregnancy-related group A streptococcal infections: Retrospective 13-year cohort study. Clin. Microbiol. Infect. 2019, 25, 251.e251-251.e254. https://doi.org/10.1016/j.cmi.2018.10.002

Olp RJ, Chamales IA, Schmiedecke SS. A case study of puerperal Group A Streptococcal infection complicated by toxic shock syndrome. Am. J. Perinatol. Rep. 2020, 10, e1. https://doi.org/10.1055/s-0039-1697648

Tartof SY, Reis JN, Andrade AN, Ramos RT, Reis MG, Riley LW. Factors associated with Group A streptococcus emm type diversification in a large urban setting in Brazil: A cross-sectional study. BMC Infect. Dis. 2010, 10, 327. https://doi.org/10.1186/1471-2334-10-327.

Weiss K, Laverdiere M, Lovgren M, Delorme J, Poirier L, Beliveau C. Group A Streptococcus carriage among close contacts of patients with invasive infections. Am. J. Epidemiol. 1999, 149, 863-868. https://doi.org/10.1093/oxfordjournals.aje.a009902

Demoré B, Tebano G, Gravoulet J, Wilcke C, Ruspini E, Birgé J, et al. Rapid antigen test use for the management of group A streptococcal pharyngitis in community pharmacies. Eur. J. Clin. Microbiol. Infect. Dis. 2018, 37, 1637-1645.

https://doi.org/10.1007/s10096-018-3293-8.

Rivera-Hernandez T, Rhyme MS, Cork AJ, Jones S, Segui-Perez C, Brunner L, et al. Vaccine-induced Th1-type response protects against invasive group A streptococcus infection in the absence of opsonizing antibodies. mBio 2020, 11. https://doi.org/10.1128/mBio.00122-20

Block SS. Disinfection, Sterilization, and Preservation, 5th ed.; Lippincott Williams and Wilkins: Philadelphia, PA, USA, 2001; p. 148168.

Gupta VK, Sekhar S, Dhanda V, Toor D, Kumar R, Chakraborti A. Immune response against M protein-conserved region peptides from prevalent group A streptococcus in a North Indian population. J. Microbiol. Immunol. 2016, 49, 352-358.

https://doi.org/10.1016/j.jmii.2014.05.008

Seth A, Kong IG, Lee SH, Yang JY, Lee YS, Kim Y, et al. Modular virus-like particles for sublingual vaccination against group A streptococcus. Vaccine 2016, 34, 6472-6480. https://doi.org/10.1016/j.vaccine.2016.11.008

Banigo A, Moinie A, Bleach N, Chand M, Chalker V, Lamagni T. Have reducing tonsillectomy rates in England led to increasing incidence of invasive Group-A Streptococcus infections in children? Clin. Otolaryngol. 2018, 43, 912-919.

https://doi.org/10.1111/coa.13095

Centers for Disease Control and Prevention. Respiratory Hygiene/Cough Etiquette in Healthcare Settings. Available online: https://www.cdc.gov/flu/professionals/infectioncontrol/resphygiene.htm

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Published

27.04.2023

How to Cite

1.
Ali MA, Kadhim SJ, Al-Bayaa YJ. A Review article of Streptococcus pyogenes Infection: Rick factors, Prevention and Management Strategies. J Fac Med Baghdad [Internet]. 2023 Apr. 27 [cited 2024 Dec. 19];65(1):79-85. Available from: https://iqjmc.uobaghdad.edu.iq/index.php/19JFacMedBaghdad36/article/view/2041

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