OBJECTIVE: To explore whether streptococcal infection may aggravate renal damage in children with Henoch-Schönlein purpura nephritis and its possible mechanism. METHODS: In the study, 485 children diagnosed with Henoch-Schönlein purpura nephritis from July 2015 to December 2019 were selected to analyze their clinical data retrospectively. According to the diagnosis of discharge, whether it was combined with streptococcal infection, the children were divided into two groups. The experimental group contained 91 children with Henoch-Schönlein purpura nephritis combined with streptococcal infection, and there were 394 children who were not infected with Streptococcus in the control group. Suitable test items were preliminarily selected through artificial neural network, and then data analysis was performed through SPSS 23.0. RESULTS: The children with Henoch-Schönlein purpura nephritis infected with streptococcus had statistically significant differences compared with the uninfected children in the test items of urine protein, liver and kidney function, immunoglobulin and complement. Anti-streptolysin O had mild correlation with IgG (Spearman r=-0.328), fibrin degradation products (Spearman r=-0.207), total protein (Spearman r=-0.202) and globulin (Spearman r=-0.223). Compared with the children who were not infected with streptococcus, the differences of the average levels of age (P=0.001), IgG (P < 0.001), fibrin degradation products (P=0.019), total protein (P < 0.001), globulin (P < 0.001), IgA (P < 0.001), IgM (P=0.003), complement 3 (P=0.016), complement 4 (P=0.002), albumin/globulin ratio (P=0.007), alkaline phosphatase (P=0.036), and estimated glomerular filtration rate (P=0.039) in the infected children were statistically significant. In order to explore the risk factors of kidney damage in the children with Henoch-Schönlein purpura nephritis, Logistic regression was performed using anti-streptolysin O, age, immunoglobulin and complement as independent variables, urine protein detection parameters, liver and kidney functions as dependent variables. Age ≤10 years old and hypocomplementemia might be risk factors for aggravating renal damage in the children with Henoch-Schönlein purpura nephritis. CONCLUSION Streptococcal infections may aggravate renal damage in children with Henoch-Schönlein purpura nephritis, in which hypocomplementemia, inflammation, fibrinolysis and disorders of coagulation perhaps play an important role. Children with streptococcal infection should be treated with anti-infective treatment in time and necessarily, and followed up after discharge regularly.
Humans ; IgA Vasculitis/complications* ; Streptococcal Infections/complications* ; Child ; Male ; Female ; Nephritis/microbiology* ; Retrospective Studies ; Child, Preschool ; Kidney/pathology* ; Adolescent

BACKGROUND: Viridans group streptococci (VGS) are both commensal microbes and potential pathogens. Increasing resistance to penicillin in VGS is an ongoing issue in the clinical environment. We investigated the difference in susceptibility and resistance to penicillin among various VGS species. METHODS: In total 1,448 VGS isolated from various clinical specimens were analyzed over a two-yr period. Identification and antimicrobial susceptibility test was performed by the automated VITEK 2 system (bioMerieux, France) or the MicroScan MICroSTREP system (Siemens, Germany). RESULTS: Among the 1,448 isolates, 412 were isolated from blood (28.4%). Streptococcus mitis group was the most frequently isolated (589 isolates, 40.7%), followed by the S. anginosus group (290 isolates, 20.0%), S. sanguinis group (179 isolates, 12.4%) and S. salivarius group (57 isolates, 3.9%). In total, 314 isolates could not be identified up to the species level. The overall non-susceptibility to penicillin was observed to be 40.0% (resistant, 11.2% and intermediately resistant, 28.8%) with uneven distribution among groups; 40.2% in S. sanguinis group (resistant, 5.0% and intermediately resistant, 35.2%), 60.3% in S. mitis group (resistant, 20.9% and intermediately resistant, 39.4%), 78.9% in S. salivarius group (resistant, 8.8% and intermediately resistant, 70.1%), and 6.2% in S. anginosus group (resistant, 1.7% and intermediately resistant, 4.5%). CONCLUSIONS: Antimicrobial resistance patterns towards penicillin show differences among various VGS; this should be considered while devising an effective antimicrobial treatment against VGS.
Anti-Infective Agents/*pharmacology ; Body Fluids/microbiology ; Drug Resistance, Bacterial ; Humans ; Microbial Sensitivity Tests ; Penicillins/pharmacology ; Streptococcal Infections/microbiology/pathology ; Viridans Streptococci/*drug effects/isolation & purification

Child, Preschool ; Female ; Humans ; Male ; Shock, Septic ; etiology ; microbiology ; Streptococcal Infections ; complications ; pathology

OBJECTIVETo describe the clinical and epidemiological features of dead cases with human Streptococcus suis infections, and to find the target population for preventing death and the related indicators.

METHODSEpidemiological investigation on human Streptococcus suis infections was implemented used unified questionnaires. Analysis on dead cases and survival cases (as contrast) was done.

RESULTSThe population with highest fatality rate was in 40-49 age group. 97.37% of dead cases had toxic shock syndrome. The mean interval from onset to admission was 0.76 days, and the mean course was 2.11 days. The progression among dead cases was faster than that among survival cases. Chief clinical manifestations of dead cases that are more frequent than survival cases are purpura (73.68%), diarrhea (50.0%), dyspnea (21.05%), conjunctival congestion (34.21%), etc. Renal impairment and liver involvement in dead cases were more significant than that in survival cases. No significant difference between mean incubation period, exposure rates of main risk factors in dead cases and in survival cases was found.

CONCLUSIONPreventing toxic shock syndrome might reduce the fatality rate. The target population for preventing death is aged > or = 40. Liver function and renal function testing might be indicators for monitoring the progression of human Streptococcus suis infections.

Adult ; Aged ; China ; Disease Progression ; Female ; Humans ; Male ; Middle Aged ; Streptococcal Infections ; blood ; microbiology ; mortality ; pathology ; Streptococcus suis ; physiology ; Young Adult

Animals ; China ; epidemiology ; Humans ; Risk ; Streptococcal Infections ; epidemiology ; microbiology ; pathology ; prevention & control ; Streptococcus suis ; classification ; isolation & purification ; metabolism ; pathogenicity ; Virulence Factors ; metabolism