Clinical aspects of invasive infections with Streptococcus dysgalactiae ssp. equisimilis in Japan: Differences with respect to Streptococcus pyogenes and Streptococcus agalactiae infections

T. Takahashi, K. Sunaoshi, K. Sunakawa, S. Fujishima, H. Watanabe, K. Ubukata

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Streptococcus dysgalactiae ssp. equisimilis (SDSE) is increasingly being identified as a pathogen responsible for invasive and non-invasive infections. We compared the clinical features of invasive SDSE infections with those of invasive infections caused by Streptococcus pyogenes (group A streptococcus (GAS)) and Streptococcus agalactiae (group B streptococcus (GBS)). Active surveillance for invasive SDSE, GAS and GBS was maintained over 1 year at 142 medical institutions throughout Japan. Clinical information was collected together with isolates, which were characterized microbiologically. Two hundred and thirty-one invasive SDSE infections were identified, 97 other patients had infections with GAS, and 151 had infections with GBS. The median age of the SDSE patients was 75 years; 51% were male and 79% had underlying diseases. Forty-two SDSE patients (19%) presented to the emergency department. Among the 150 patients (65%) for whom follow-up was completed, 19 (13%) died and eight (5%) had post-infective sequelae (poor outcome). Insufficient white blood cell responses (<5000 cells/μL) and thrombocytopenia on admission each suggested significantly higher risk of poor outcome (ORs 3.6 and 4.5, respectively). Of 229 isolates, 55 (24%) showed an stG6792 emm type, which was significantly associated with poor outcome (OR 2.4). Clinical manifestations of invasive SDSE infections were distinct from those of invasive GBS infections. Primary-care doctors should consider invasive SDSE infections when treating elderly patients.

Original languageEnglish
Pages (from-to)1097-1103
Number of pages7
JournalClinical Microbiology and Infection
Issue number8
Publication statusPublished - 2010 Aug



  • Invasive infections
  • Non-invasive infections
  • Streptococcus agalactiae
  • Streptococcus dysgalactiae ssp. equisimilis
  • Streptococcus pyogenes

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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