A Genetic-Based Evaluation of the Principal Tissue Reservoir for Group A Streptococci Isolated from Normally Sterile Sites

• Published in: The Journal of infectious diseases Vol. 176; no. 1; pp. 177 - 182
• Main Authors: Fiorentino, Therese R., Beall, Bernard, Mshar, Patricia, Bessen, Debra E.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.07.1997; University of Chicago Press
• Subjects: Bacterial diseases; Base Sequence; Biological and medical sciences; Chromosomes, Bacterial; Disease reservoirs; DNA; Emerging diseases; Epidemiology; Genes; Genetic Markers; Human bacterial diseases; Humans; Impetigo; Impetigo - microbiology; Infections; Infectious diseases; Lesions; Major Articles; Medical sciences; Molecular Sequence Data; Nasopharyngeal diseases; Nasopharynx - microbiology; Polymerase chain reaction; Staphylococcal infections, streptococcal infections, pneumococcal infections; Streptococcus pyogenes - genetics; Streptococcus pyogenes - isolation & purification; Infectious focus; Human; Reservoir; Nasopharynx; Epidemiology; Infection; Streptococcaceae; Streptococcal infection; Impetigo; Streptococcus A; Bacteriosis; Bacteria; Micrococcales; Skin
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/514020

The primary sites of infection and principal reservoirs for transmission of group A streptococci are the nasopharyngeal mucosa and the impetigo lesion. However, pharyngitis and impetigo are rarely observed prior to invasive disease, and, thus, the origin of invasive strains is largely unknown. As part of an active surveillance program, group A streptococci were obtained from normally sterile tissue sites of Connecticut residents during a 6-month period. Organisms were analyzed for genetic markers that distinguish between strains that use the nasopharynx versus an impetiginous lesion as their primary site for infection. The nasopharyngeal marker was observed for most sterile-site isolates, suggesting that the upper respiratory tract is the principal reservoir from which organisms causing invasive disease are disseminated. Genotypic analyses of sterile-site isolates support the view that additional factors, aside from a recent emergence of a few virulent clones, are important contributors to invasive group A streptococcal disease.