Emerging infection: streptococcal toxic shock-like syndrome caused by group B Streptococcus (GBS), Streptococcus agalactiae
Fareed Rajack; Shawn Medford; Ali Ramadan; Tammey Naab
Abstract
Keywords
References
1 Bobadilla FJ, Novosak MG, Cortese IJ, Delgado OD, Laczeski ME. Prevalence, serotypes and virulence genes of Streptococcus agalactiae isolated from pregnant women with 35-37 weeks of gestation. BMC Infect Dis. 2021;21(1):73.
2 Filkins L, Hauser JR, Robinson-Dunn B, Tibbetts R, Boyanton BL, Revell P. American Society for Microbiology Provides 2020 Guidelines for Detection and Identification of Group B
3 Baker CJ, Barrett FF. Group B streptococcal infections in infants. The importance of the various serotypes. JAMA. 1974;230(8):1158-60.
4 Horn KA, Group B. Streptococcal neonatal infection. JAMA. 1974;230(8):1165-7.
5 Russell NJ, Seale AC, O’Driscoll M, et al. Maternal colonization with Group B streptococcus and serotype distribution worldwide: systematic review and meta-analyses. Clin Infect Dis. 2017;65(Suppl 2):S100-11.
6 Lawn JE, Bianchi-Jassir F, Russell NJ, et al. Streptococcal disease worldwide for pregnant women, stillbirths, and children: why, what, and how to undertake estimates? Clin Infect Dis. 2017;65(Suppl 2):S89-99.
7 Sendi P, Johansson L, Norrby-Teglund A. Invasive group B Streptococcal disease in nonpregnant adults : a review with emphasis on skin and soft-tissue infections. Infection. 2008;36(2):100-11.
8 Schrag SJ, Zywicki S, Farley MM, et al. Group B streptococcal disease in the era of intrapartum antibiotic prophylaxis. N Engl J Med. 2000;342(1):15-20.
9 Zangwill KM, Schuchat A, Wenger JD. Group B streptococcal disease in the United States, 1990: report from a multistate active surveillance system. MMWR CDC Surveill Summ. 1992;41(6):25-32. PMid:1470102.
10 Nanduri SA, Petit S, Smelser C, et al. Epidemiology of invasive early-onset and late-onset Group B streptococcal disease in the United States, 2006 to 2015: multistate laboratory and population-based surveillance. JAMA Pediatr. 2019;173(3):224-33.
11 Al Akhrass F, Abdallah L, Berger S, et al. Streptococcus agalactiae toxic shock-like syndrome: two case reports and review of the literature. Medicine (Baltimore). 2013;92(1):10-4.
12 Skoff TH, Farley MM, Petit S, et al. Increasing burden of invasive group B streptococcal disease in nonpregnant adults, 1990-2007. Clin Infect Dis. 2009;49(1):85-92.
13 Francois Watkins LK, McGee L, Schrag SJ, et al. Epidemiology of invasive Group B streptococcal infections among nonpregnant adults in the United States, 2008-2016. JAMA Intern Med. 2019;179(4):479-88.
14 Centers for Disease Control and Prevention (CDC). Active Bacterial Core Surveillance (ABCs) Report Emerging Infections Program Network Group A
15 Centers for Disease Control and Prevention (CDC). Active Bacterial Core Surveillance (ABCs). Report Emerging Infections Program Network
16 Muñoz P, Llancaqueo A, Rodríguez-Créixems M, Peláez T, Martin L, Bouza E. Group B streptococcus bacteremia in nonpregnant adults. Arch Intern Med. 1997;157(2):213-6.
17 Farley MM. Group B streptococcal disease in nonpregnant adults. Clin Infect Dis. 2001;33(4):556-61.
18 Farley MM, Harvey RC, Stull T, et al. A population-based assessment of invasive disease due to group B Streptococcus in nonpregnant adults. N Engl J Med. 1993;328(25):1807-11.
19 Schwartz B, Schuchat A, Oxtoby MJ, Cochi SL, Hightower A, Broome CV. Invasive group B streptococcal disease in adults. A population-based study in metropolitan Atlanta. JAMA. 1991;266(8):1112-4.
20 Harrison LH, Ali A, Dwyer DM, et al. Relapsing invasive group B streptococcal infection in adults. Ann Intern Med. 1995;123(6):421-7.
21 Phares CR, Lynfield R, Farley MM, et al. Epidemiology of invasive group B streptococcal disease in the United States, 1999-2005. JAMA. 2008;299(17):2056-65.
22 Jackson LA, Hilsdon R, Farley MM, et al. Risk factors for group B streptococcal disease in adults. Ann Intern Med. 1995;123(6):415-20.
23 Manning SD, Tallman P, Baker CJ, Gillespie B, Marrs CF, Foxman B. Determinants of co-colonization with group B streptococcus among heterosexual college couples. Epidemiology. 2002;13(5):533-9.
24 Todd J, Fishaut M, Kapral F, Welch T. Toxic-shock syndrome associated with phage-group-I Staphylococci. Lancet. 1978;312(8100):1116-8.
25 Hansen NS, Leth S, Nielsen LT. Toxic shock syndrome. Ugeskr Laeger. 2020;182(20):V11190673. PMid:32400378.
26 Silversides JA, Lappin E, Ferguson AJ. Staphylococcal toxic shock syndrome: mechanisms and management. Curr Infect Dis Rep. 2010;12(5):392-400.
27 Burnham JP, Kollef MH. Understanding toxic shock syndrome. Intensive Care Med. 2015;41(9):1707-10.
28 Hajjeh RA, Reingold A, Weil A, Shutt K, Schuchat A, Perkins BA. Toxic shock syndrome in the United States: surveillance update, 1979 1996. Emerg Infect Dis. 1999;5(6):807-10.
29 Venkataraman R. Toxic Shock Syndrome. Newark: Medscape; 2023 [cited 2023 Sep 26]. Available from:
30 Javid Khojasteh V, Rogan MT, Edwards-Jones V, Foster HA. Detection of antibodies to Staphylococcus aureus Toxic Shock Syndrome Toxin-1 using a competitive agglutination inhibition assay. Lett Appl Microbiol. 2003;36(6):372-6.
31 Cone LA, Woodard DR, Schlievert PM, Tomory GS. Clinical and bacteriologic observations of a toxic shock-like syndrome due to Streptococcus pyogenes. N Engl J Med. 1987;317(3):146-9.
32 Breiman RF. Defining the group A streptococcal toxic shock syndrome. Rationale and consensus definition. The Working Group on Severe Streptococcal Infections. JAMA. 1993;269(3):390-1.
33 Stevens DL, Tanner MH, Winship J, et al. Severe group A streptococcal infections associated with a toxic shock-like syndrome and scarlet fever toxin A. N Engl J Med. 1989;321(1):1-7.
34 Khan Z. Group A Streptococcal (GAS) Infections. Newark: Medscape; 2023 [cited 2023 Sep 26]. Available from:
35 Balk RA. SIRS, Sepsis, and Septic Shock Criteria
36 Wang YS, Wong CH, Tay YK. Staging of necrotizing fasciitis based on the evolving cutaneous features. Int J Dermatol. 2007;46(10):1036-41.
37 Bakleh M, Wold LE, Mandrekar JN, Harmsen WS, Dimashkieh HH, Baddour LM. Correlation of histopathologic findings with clinical outcome in necrotizing fasciitis. Clin Infect Dis. 2005;40(3):410-4.
38 Edwards MS, Baker CJ. Group B streptococcal infections in elderly adults. Clin Infect Dis. 2005;41(6):839-47.
39 Amaya RA, Baker CJ, Keitel WA, Edwards MS. Healthy elderly people lack neutrophil-mediated functional activity to type V group B Streptococcus. J Am Geriatr Soc. 2004;52(1):46-50.
40 Palazzi DL, Rench MA, Edwards MS, Baker CJ. Use of type V group B streptococcal conjugate vaccine in adults 65-85 years old. J Infect Dis. 2004;190(3):558-64.
41 Baker CJ, Webb BJ, Kasper DL, Edwards MS. The role of complement and antibody in opsonophagocytosis of type II group B streptococci. J Infect Dis. 1986;154(1):47-54.
42 Mazade MA, Edwards MS. Impairment of type III group B Streptococcus-stimulated superoxide production and opsonophagocytosis by neutrophils in diabetes. Mol Genet Metab. 2001;73(3):259-67.
43 Tang WM, Ho PL, Yau WP, Wong JW, Yip DK. Report of 2 fatal cases of adult necrotizing fasciitis and toxic shock syndrome caused by Streptococcus agalactiae. Clin Infect Dis. 2000;31(4):E15-7.
44 Tyrrell GJ, Senzilet LD, Spika JS, et al. Invasive disease due to group B streptococcal infection in adults: results from a Canadian, population-based, active laboratory surveillance study--1996. Sentinel Health Unit Surveillance System Site Coordinators. J Infect Dis. 2000;182(1):168-73.
45 Fukuda K, Ryujin M, Sakio R, Fukuzumi S, Omae T, Hayakawa K. Bilateral necrotizing fasciitis of the foot associated with Group B streptococcus. Case Rep Dermatol. 2016;8(3):243-9.
46 Centers for Disease Control and Prevention [Internet]. Streptococcus Laboratory: Streptococcus agalactiae. USA: CDC; 2023 [cited 2023 Sep 26]. Available from:
47 Baker CJ, Edwards MS, Kasper DL. Role of antibody to native type III polysaccharide of group B Streptococcus in infant infection. Pediatrics. 1981;68(4):544-9.
48 Umemura H, Hiragushi K, Sasaki S, et al. A male with group B streptococcal necrotizing fasciitis at multiple sites secondary to multifocal septic arthritis. Acta Derm Venereol. 2015;95(5):614-5.
49 Sendi P, Johansson L, Dahesh S, et al. Bacterial phenotype variants in group B streptococcal toxic shock syndrome. Emerg Infect Dis. 2009;15(2):223-32.
50 Marques MB, Kasper DL, Pangburn MK, Wessels MR. Prevention of C3 deposition by capsular polysaccharide is a virulence mechanism of type III group B streptococci. Infect Immun. 1992;60(10):3986-93.
51 Puliti M, Nizet V, von Hunolstein C, et al. Severity of group B streptococcal arthritis is correlated with beta-hemolysin expression. J Infect Dis. 2000;182(3):824-32.
52 Cornacchione P, Scaringi L, Fettucciari K, et al. Group B streptococci persist inside macrophages. Immunology. 1998;93(1):86-95.
53 Liu GY, Doran KS, Lawrence T, et al. Sword and shield: linked group B streptococcal beta-hemolysin/cytolysin and carotenoid pigment function to subvert host phagocyte defense. Proc Natl Acad Sci USA. 2004;101(40):14491-6.
54 Souza VC, Kegele FC, Souza SR, Neves FP, de Paula GR, Barros RR. Antimicrobial susceptibility and genetic diversity of Streptococcus agalactiae recovered from newborns and pregnant women in Brazil. Scand J Infect Dis. 2013;45(10):780-5.
55 Larsson C, Lindroth M, Nordin P, Stålhammar-Carlemalm M, Lindahl G, Krantz I. Association between low concentrations of antibodies to protein alpha and Rib and invasive neonatal group B streptococcal infection. Arch Dis Child Fetal Neonatal Ed. 2006;91(6):F403-8.
56 Lindahl G, Akerström B, Vaerman JP, Stenberg L. Characterization of an IgA receptor from group B streptococci: specificity for serum IgA. Eur J Immunol. 1990;20(10):2241-7.
57 Pleass RJ, Areschoug T, Lindahl G, Woof JM. Streptococcal IgA-binding proteins bind in the Calpha 2-Calpha 3 interdomain region and inhibit binding of IgA to human CD89. J Biol Chem. 2001;276(11):8197-204.
58 Pietrocola G, Visai L, Valtulina V, et al. Multiple interactions of FbsA, a surface protein from Streptococcus agalactiae, with fibrinogen: affinity, stoichiometry, and structural characterization. Biochemistry. 2006;45(42):12840-52.
59 Schubert A, Zakikhany K, Pietrocola G, et al. The fibrinogen receptor FbsA promotes adherence of Streptococcus agalactiae to human epithelial cells. Infect Immun. 2004;72(11):6197-205.
60 Lindahl G, Stålhammar-Carlemalm M, Areschoug T. Surface proteins of Streptococcus agalactiae and related proteins in other bacterial pathogens. Clin Microbiol Rev. 2005;18(1):102-27.
61 Madoff LC, Michel JL, Gong EW, Kling DE, Kasper DL. Group B streptococci escape host immunity by deletion of tandem repeat elements of the alpha C protein. Proc Natl Acad Sci USA. 1996;93(9):4131-6.
62 Luan SL, Granlund M, Sellin M, Lagergård T, Spratt BG, Norgren M. Multilocus sequence typing of Swedish invasive group B streptococcus isolates indicates a neonatally associated genetic lineage and capsule switching. J Clin Microbiol. 2005;43(8):3727-33.
63 Cornacchione P, Scaringi L, Fettucciari K, et al. Group B streptococci persist inside macrophages. Immunology. 1998;93(1):86-95.
64 Nawijn F, Smeeing DPJ, Houwert RM, Leenen LPH, Hietbrink F. Time is of the essence when treating necrotizing soft tissue infections: a systematic review and meta-analysis. World J Emerg Surg. 2020;15(1):4.
65 Gelbard RB, Ferrada P, Yeh DD, et al. Optimal timing of initial debridement for necrotizing soft tissue infection: a Practice Management Guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2018;85(1):208-14.
66 Berner R. Group B streptococcus vaccines: one step further. Lancet Infect Dis. 2021;21(2):158-60.
67 Carreras-Abad C, Ramkhelawon L, Heath PT, Le Doare K. A vaccine against Group B Streptococcus: recent advances. Infect Drug Resist. 2020;13:1263-72.
Submitted date:
09/26/2023
Accepted date:
04/25/2024
Publication date:
06/21/2024