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Modern concepts of diseases caused by group A Streptococcus (lecture)

https://doi.org/10.22627/2072-8107-2026-25-2-55-62

Abstract

The lecture is devoted to modern concepts of the diseases caused by Group A β-hemolytic Streptococcus. The main microbiological characteristics of the pathogen, pathogenicity factors, epidemiological patterns and clinical features of various nosological forms, consequences of acute infection, with an assessment of the disease burden are presented. Various methods of etiological diagnostics, their advantages and disadvantages are considered. Particular attention is devoted to the problem of antibiotic resistance, which is becoming increasingly global in modern conditions. The article presents prospects for the prevention of streptococcal infection, active immunization as a potentially effective way to reduce the incidence and spread of infection in the population. The effectiveness of timely methods of diagnosis, therapy, and vaccination against group A streptococcal infection are important areas for further research.

About the Authors

A. I. Demchenko
Saint Petersburg Pediatric Medical University
Russian Federation

Saint Petersburg



N. S. Tian
Federal Scientific and Clinical Center for Infectious Diseases
Russian Federation

Saint Petersburg



I. V. Babachenko
Saint Petersburg Pediatric Medical University; Federal Scientific and Clinical Center for Infectious Diseases
Russian Federation

Saint Petersburg



References

1. Infectious diseases in children: textbook for medical students. Timchenko VN, editor. 5th ed. Saint Petersburg: SpetsLit; 2023. 895 p. (In Russ).

2. Zhdanov KV, Chirsky VS, Kovalenko AN, Zakharenko SM, Bushurov SE, Sarana AM, Yurkaev IM, Kovalenko NA. Invasive streptococcal infection: clinical case and pathomorphological manifestations. Military Medical Journal. 2017;338(11):70—72. (In Russ).

3. Levina AS, Babachenko IV, Chuprova SN, Kochevaya NV, Sharipova EV, Ibragimova OM. A case of cardiac involvement in mixed streptococcal and EpsteinBarr viral infection. Pediatrician. 2016;7(3):147—152. doi: 10.17816/PED73147-152 (In Russ).

4. Reference book on infectious diseases in children. Lobzin YuV, editor. Saint Petersburg: SpetsLit; 2013. 591 p. (In Russ).

5. Davies MR, Keller N, Brouwer S, Jespersen MG, Cork AJ, Hayes AJ, Pitt ME, De Oliveira DMP, Harbison-Price N, Bertolla OM, Mediati DG, Curren BF, Taiaroa G, Lacey JA, Smith HV, Fang NX, Coin LJM, Stevens K, Tong SYC, SandersonSmith M, Tree JJ, Irwin AD, Grimwood K, Howden BP, Jennison AV, Walker MJ. Detection of Streptococcus pyogenes M1UK in Australia and characterization of the mutation driving enhanced expression of superantigen SpeA. Nat Commun. 2023;14:1—12. doi: 10.1038/s41467-023-36717-4

6. Jespersen MG, Lacey JA, Tong SYC, Davies MR. Global genomic epidemiology of Streptococcus pyogenes. Infect Genet Evol. 2020;86:1—13. doi: 10.1016/j.meegid.2020.104609

7. Mavroidi A, Katsiaflaka A, Petinaki E, Froukala E, Papadopoulos D, Vrioni G, Tsakris A. M1UK Streptococcus pyogenes causing community-acquired pneumonia, pleural empyema and streptococcal toxic shock syndrome. J Glob Antimicrob Resist. 2024;37:185—189. doi: 10.1016/j.jgar.2024.03.016

8. Prevention of streptococcal (group A) infection. Clinical recommendations. Moscow: Ministry of Health of the Russian Federation; 2013. 41 p. (In Russ).

9. Medical microbiology, virology and immunology: textbook in 2 volumes. Zverev VV, Boychenko MN, editors. 2nd ed. Moscow: GEOTAR-Media; 2019. Vol. 2. 472 p. (In Russ).

10. de Arellano ER, Saavedra-Lozano J, Villalon P, Jové-Blanco A, Grandioso D, Sotelo J, Gamell A, González-López JJ, Cervantes E, Gónzalez MJ, Rello-Saltor V, Esteva C, Sanz-Santaeufemia F, Yagüe G, Manzanares Á, Brañas P, Ruiz de Gopegui E, Carrasco-Colom J, García F, Cercenado E, Mellado I, Del Castillo E, Pérez-Vazquez M, Oteo-Iglesias J, Calvo C. Clinical, microbiological, and molecular characterization of pediatric invasive infections by Streptococcus pyogenes in Spain in a context of global outbreak. mSphere. 2024;9(3):1—13. doi: 10.1128/msphere.00729-23

11. Ferretti JJ, Stevens DL, Fischetti VA. Streptococcus pyogenes: basic biology to clinical manifestation. 2nd ed. Oklahoma City (OK): University of Oklahoma Health Sciences Center; 2022. 781 p.

12. Vieira A, Wan Y, Ryan Y, Li HK, Guy RL, Papangeli M, Huse KK, Reeves LC, Soo VWC, Daniel R, Harley A, Broughton K, Dhami C, Ganner M, Ganner MA, Mumin Z, Razaei M, Rundberg E, Mammadov R, Mills EA, Sgro V, Mok KY, Didelot X, Croucher NJ, Jauneikaite E, Lamagni T, Brown CS, Coelho J, Sriskandan S. Rapid expansion and international spread of M1UK in the post-pandemic UK upsurge of Streptococcus pyogenes. Nat Commun. 2024;15:1—11. doi: 10.1038/s41467-024-47929-7

13. Yatsyshina SB, Mamoshina MV, Elkina MA, Polyaeva OA, Mikhailova YuV, Shenlenkov AA, Egorova AE, Maleev VV. Invasive group A streptococcal infection with fulminant course in children. Infection and Immunity. 2023;13(6):1009—1017. doi: 10.15789/2220-7619-FIG-15637 (In Russ).

14. Brouwer S, Rivera-Hernandez T, Curren BF, Harbison-Price N, De Oliveira DMP, Jespersen MG, Davies MR, Walker MJ. Pathogenesis, epidemiology and control of Group A streptococcus infection. Nat Rev Microbiol. 2023;21:431—447. doi: 10.1038/s41579-023-00865-7

15. Lynskey NN, Jauneikaite E, Li HK, Zhi X, Turner CE, Mosavie M, Pearson M, Asai M, Lobkowicz L, Chow JY, Parkhill J, Lamagni T, Chalker VJ, Sriskandan S. Emergence of a dominant toxigenic clone of Streptococcus pyogenes M1T1 during an increase in scarlet fever activity in England: a population-based molecular epidemiological study. Lancet Infect Dis. 2019;19(11):1209—1218. doi: 10.1016/S1473-3099(19)30446-3

16. Chiang-Ni C, Hsu C-Y, Yeh Y-H, Chi C-Y, Wang S, Tsai P-J, Chiu C-H. Detection of toxigenic M1UK lineage group A Streptococcus clones in Taiwan. J Microbiol Immunol Infect. 2024;52(2):269—277. doi: 10.1016/j.jmii.2024.01.004

17. Zhi X, Li HK, Li H, Loboda Z, Charles S, Vieira A, Huse K, Jauneikaite E, Reeves L, Mok KY, Coelho J, Lamagni T, Sriskandan S. Emerging Invasive Group A Streptococcus M1UK Lineage Detected by Allele-Specific PCR, England, 2020. Emerg Infect Dis. 2023;5(5):1007—1010. doi: 10.3201/eid2905.221887

18. Aksenova AV, Abeldyaev DV, Glushakov EV. Epidemiological aspects of streptococcal and post-streptococcal diseases in the Russian Federation at the present stage. Journal of Clinician. 2020;14(1-2):14—23. doi: 10.17650/1818-8338-2020-14-1-2-14-23 (In Russ).

19. Anokhin VA. Streptococcal infection in children and adolescents. Practical Medicine. 2008;7(31):8—14. (In Russ).

20. Briko NI, Glushakova EV, Kakorina EP, Nikitin NV. Streptococcal (group A) infection in Russia: state of the problem and development trends. Journal of Infectology. 2019;11(1):7—16. doi: 10.22625/2072-6732-2019-11-1-7-16 (In Russ).

21. Keeley AJ, Groves D, Armitage EP, Senghore E, Jagne YJ, Sallah HJ, Drammeh S, Angyal A, Hornsby H, de Crombrugghe G, Smeesters PR, Rossi O, Carducci M, Peno C, Bogaert D, Kampmann B, Marks M, Shaw HA, Turner CR, de Silva TI. Streptococcus pyogenes colonization in children aged 24-59 month in the Gambia: impact of live attenuated influenza vaccine and associated serological responses. J Infect Dis. 2023:957—965. doi: 10.1093/infdis/jiad153

22. Ohashi A, Murayama MA, Miyabe Y, Yudoh K, Miyabe C. Streptococcal infection and autoimmune disease. Front Immunol. 2024;15:1—7. doi: 10.3389/fimmu.2024.1361123

23. Iskova IA, Klyaritskaya IL, Tsapyak TA, Krivoi VV. Group A streptococcal infection: its significance and diagnosis. Crimean Therapeutic Journal. 2021;1:32—36. (In Russ).

24. Plavunov NF, Kadyshev VA, Kim SS, Goncharova NA. Diagnosis of streptococcal infection for emergency department physicians: first experience with «streptatest». Archives of Internal Medicine. 2020;6:475—482. doi: 10.20514/22266704-2020-10-6-475-482 (In Russ).

25. Clinical recommendations «Acute tonsillitis and pharyngitis (acute tonsillopharyngitis)». Available at: https://cr.minzdrav.gov.ru/recomend/306_2 (cited 2024 Dec 14). (In Russ).

26. Yu J, Tycksen E, Yang W, Mariani TJ, Bhattacharya S, Falsey AR, Topham DJ, Storch GA. Use of host response to refine the diagnosis of group A streptococcal pharyngitis. J Pediatric Infect Dis Soc. 2022;11:482—491. doi: 10.1093/jpids/piac072

27. Glushkova EV, Brazhnikov AYu, Krasnova SV, Glazovskaya LS, Savkina AA, Nikitin NV, Korshunov VA, Briko NI. Clinical and epidemiological characteristics of scarlet fever in Russia. Epidemiology and Vaccinal Prevention. 2023;22(3):14—25. doi:10.31631/2073-3046-2023-22-3-14-25 (In Russ).

28. Clinical recommendations (treatment protocol) for providing medical care to children with scarlet fever. Moscow: FSBI Research Institute of Children's Infections FMBA of Russia; 2015. 69 p. (In Russ).

29. Briko NI, Nikitin NV, Glushkova EV, Kodalaeva MV, Shaova KT, Mazankova LN, Korsunsky AA. Clinical manifestations of scarlet fever in children in a metropolis at the present stage. Russian Medical Journal. 2024;30(4):336—347. doi:10.17816/medjrf630935 (In Russ).

30. SanPiN 3.3686-21 «Sanitary and epidemiological requirements for the prevention of infectious diseases». Moscow; 2021. 1092 p. (In Russ).

31. Ivanchik NV, Sukhorukova MV, Chagaryan AN, Dekhnich AV, Kozlov RS, Andreev VA, Bekker GG, Varganova AN, Gudkova LV, Ershova MG, Zholobova AF, Zubareva NA, Iskhakova LM, Kirillova GSh, Krechikova OI, Lazareva AV, Morozova OA, Moskvitina EN, Nagovitsina SG, Petrova TA, Rakhmanova OA, Salo EA, Chernyavskaya YuL, Yarantseva NZ. Antibiotic resistance of clinical strains of Streptococcus pyogenes in Russia: results of a multicenter epidemiological study «PeGAS 2014-2017». Clinical Microbiology and Antimicrobial Chemotherapy. 2020;22(1):40—45. doi: 10.36488/cmac.2020.1.40-45 (In Russ).

32. Minaeva NV. Modern strategy of antibacterial therapy of upper respiratory tract infections in children in outpatient practice. Medical Council. 2018;2:134—138. doi: 10.21518/2079-701X-2018-2-134-138 (In Russ).

33. Hung T, Phuong LK, Grobler A, Tong SYC, Freeth P, Pelenda A, Gibney KB, Steer AC. Antibiotics to eradicate Streptococcus pyogenes pharyngeal carriage in asymptomatic and adults: a systematic review. J Infect. 2024;88:1—10. doi: 10.1016/j.jinf.2024.01.003

34. Khademi F, Vaez H, Sahebkar A, Taheri A. Group A Streptococcus antibiotic resistance in Iranian children: a meta-analysis. Oman Med J. 2021;36(1):514—521. doi: 10.5001/omj.2020.79

35. Sun L, Xiao Y, Huang W, Lai J, Lyu J, Ye B, Chen H, Gu B. Prevalence and identification of antibiotic-resistant scarlet fever group A Streptococcus strains in some pediatric cases at Shenzen, China. J Glob Antimicrob Resist. 2022;30:199—204. doi: 10.1016/j.jgar.2022.05.012

36. Dale JB, Walker MJ. Update on group A Streptococcal vaccine development. Curr Opin Infect Dis. 2020;33(3):244—250. doi: 10.1097/QCO.0000000000000644

37. Smeesters PR, de Crombrugghe G, Tsoi SK, Leclercq C, Baker C, Osowicki J, Verhoeven C, Botteaux A, Steer AC. Global pyogenes strain diversity, disease associations, and implications for vaccine development: a systematic review. Lancet Microbe. 2024;5(2):181—193. doi: 10.1016/S2666-5247(23)00318-X


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For citations:


Demchenko A.I., Tian N.S., Babachenko I.V. Modern concepts of diseases caused by group A Streptococcus (lecture). CHILDREN INFECTIONS. 2026;25(2):55-62. (In Russ.) https://doi.org/10.22627/2072-8107-2026-25-2-55-62

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ISSN 2072-8107 (Print)
ISSN 2618-8139 (Online)