Invasive group A streptococcal disease.

Infectious agents and disease Pub Date : 1996-06-01
D L Stevens
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引用次数: 0

Abstract

The emergence of severe group A streptococcal (GAS) infection since the 1980s has now been reported from most parts of the world. Many of these cases have been associated with deep-seated infection associated with shock and multiple-organ failure and are defined as streptococcal toxic shock syndrome (StrepTSS). Strains of GAS isolated from patients with invasive disease have been predominantly of M types 1 and 3, which produce either pyrogenic exotoxin A or B or both. In this article, the clinical and demographic features of streptococcal bacteremia, myositis, and necrotizing fasciitis are presented and compared with those of StrepTSS. Current concepts about the pathogenesis of invasive streptococcal infection are also discussed, in terms of the interaction between GAS virulence factors and host-defense mechanisms. Finally, the efficacy of clindamycin, the failure of penicillin, and new ideas for future treatment of serious streptococcal infections are outlined.

侵袭性A群链球菌病。
自20世纪80年代以来,世界大多数地区都报告出现了严重的A群链球菌感染。这些病例中有许多与休克和多器官衰竭相关的深部感染有关,并被定义为链球菌中毒性休克综合征(StrepTSS)。从侵袭性疾病患者中分离的GAS菌株主要为M型1和3型,它们产生热原外毒素A或B或两者兼而有之。本文介绍了链球菌菌血症、肌炎和坏死性筋膜炎的临床和人口学特征,并与链球菌感染进行了比较。本文还讨论了目前关于侵袭性链球菌感染发病机制的概念,即GAS毒力因子与宿主防御机制之间的相互作用。最后,概述了克林霉素的疗效,青霉素的失败,以及未来治疗严重链球菌感染的新思路。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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