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Journal Articles Clinical Microbiology and Infection Year : 2012

Invasive group A streptococcal infections in adults, France (2006-2010)


Severe invasive group A streptococcal diseases have re-emerged during the past 10-20 years. In order to provide a better insight into the current epidemiological situation in France, we analysed the questionnaires regarding all invasive strains received at the National Reference Center for Streptococci (CNR-Strep) between 2006 and 2010 from patients aged ≥18 and characterized them by emm typing, spe gene detection and antibiotic resistance. Among the 1542 invasive GAS strains studied, 78% (n = 1206) were from blood cultures, and a streptococcal toxic shock syndrome (STSS) was described in 22% (n = 340) of cases, mainly associated with necrotizing fasciitis (NF) and pleuro-pulmonary infections (p <0.001). The in-hospital fatality rate was 15%. A total of 83 different emm types were recovered but the three predominant emm types, representing almost 60% of the isolates, were emm 1(24%), emm28 (17%) and emm89 (15%). The preponderance of each emm type varied according to the year, with a significant constant increase of emm28 strains, whereas emm1 strains, representing approximately 32% of GAS invasive isolates in 2007 and 2008, dropped to <15% in 2010 (p <0.001). The distribution of phage-associated superantigen genes (speA, speC and ssa) was linked to certain emm types. Between 2006 and 2010, the percentage that was macrolideresistant decreased from 11% to 5%, confirming the trend observed in 2007. Fortunately, emm1 strains associated with the most life-threatening clinical manifestations remain susceptible to all anti-streptococcal antibiotics.

Dates and versions

pasteur-01300168 , version 1 (08-04-2016)



C. Plainvert, A. Doloy, J. Loubinoux, A. Lepoutre, G. Collobert, et al.. Invasive group A streptococcal infections in adults, France (2006-2010). Clinical Microbiology and Infection, 2012, 18 (7), pp.702-710. ⟨10.1111/j.1469-0691.2011.03624.x⟩. ⟨pasteur-01300168⟩
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