Vol. 13. Núm. 50.
Páginas 2901-2908 (Marzo 2022)

Infecciones por estreptococo

Streptococcal infections

A. Díaz de SantiagoabS. de la Fuente MoralabI. Pintos Pascualab
Doi : https://10.1016/j.med.2022.02.019
Opciones
Resumen

Los microorganismos del género Streptococcus spp. forman un grupo de cocos grampositivos dentro del cual se incluyen patógenos humanos de relevancia como Streptococcus pneumoniae, Streptococcus pyogenes y Streptococcus agalactiae. Los estreptococos forman parte de la microbiota humana de la nasofaringe, sistema digestivo, piel y mucosas y son agentes etiológicos de un gran número de síndro- mes infecciosos como pueden ser diversas infecciones del sistema respiratorio, infecciones de piel y partes blandas, bacteriemia, endocarditis, meningitis, sepsis grave, fascitis necrotizante y el síndrome del shock tóxico. El diagnóstico de las infecciones causadas por estreptococos está basado en la combi- nación de los signos y síntomas y los resultados del estudio microbiológico. La identificación de los es- treptococos como agentes etiológicos requiere de un cultivo bacteriológico de las muestras de interés, combinado con la realización de pruebas rápidas de detección de antígenos o técnicas de biología mole- cular. Los estreptococos son sensibles a antibióticos betalactámicos. Las cefalosporinas de tercera ge- neración son los antibióticos de elección en infecciones invasoras como la bacteriemia o la meningitis, y clindamicina es de gran utilidad en la fascitis necrotizante debido a sus efectos inmunomoduladores y a la inhibición de las exotoxinas y otros factores de virulencia. Las actuales tasas de resistencia a macróli- dos desaconsejan su uso. La prevención resulta fundamental.

Palabras clave
Streptococcus spp.
Faringoamigdalitis
Piel y partes blandas
Bacteriemia
Abstract

Microorganisms of the Streptococcus spp. genus form a group of gram-positive cocci that includes notable human pathogens, such as Streptococcus pneumoniae, Streptococcus pyogenes, and Streptococcus agalactiae. Streptococci form part of the human microbiota of the nasopharynx, digestive system, skin, and mucosa and are the etiological agents of a large number of infectious diseases such as various respiratory system infections, skin and soft tissue infections, bacteremia, endocarditis, meningitis, severe sepsis, necrotizing fasciitis, and toxic shock syndrome. The diagnosis of infections caused by streptococci is based on the combination of signs and symptoms and the results of a microbiological study. The identification of streptococci as etiological agents requires a bacteria culture of the samples of interest combined with rapid antigen tests or molecular biology techniques. Streptococci are sensitive to beta-lactam antibiotics. Third- generation cephalosporins are the antibiotics of choice for invasive infections such as bacteremia or meningitis and clindamycin is of great use in necrotizing fasciitis due to its immunomodulating effects and its inhibition of exotoxins and other virulence factors. Given the current rates of macrolide resistance, their use is advised against. Prevention is fundamental.

Keywords
Streptococcus spp.
Tonsillopharyngitis
Skin and soft tissues
Bacteremia

Identifíquese

¿Aún no es suscriptor de la revista?

Comprar el acceso al artículo

Comprando el artículo el pdf del mismo podrá ser descargado

Teléfono para incidencias

De lunes a viernes de 9h a 18h (GMT+1) excepto los meses de julio y agosto que será de 9 a 15h

Llamadas desde España 932 415 960
Llamadas desde fuera de España +34 932 415 960
Bibliografía
[1]
J.P.
202203090644380348
202203090644380349
Dekker, K.L. Ruoff.
Clasificación de los estreptococos.
Mandell, Douglas y Bennett. Enfermedades Infecciosas. Principios y Práctica, Elsevier, pp. 2444-2445
[2]
M.E.
2022030906443803410
Fernández Rivero, J.L. del Pozo.
Infecciones por estreptococos.
Medicine., (2018), 12 pp. 2883-2889
[3]
M.R.
2022030906443803411
Wessels.
Infecciones estreptocócicas.
Harrison. Principios de Medicina Interna, 20ª ed., McGraw Hill, pp. 1-19
[4]
N. Hanter, N. Collin, N. Holmes, M. Binns, J. Mumford.
Characterization of the Lancefield group C streptococcus 16S-23S RNA gene intergenic spacer and its potential for identification and sub-specific typing.
Epidemiol Infect., (1997), 118 pp. 125-135
[5]
M.R.
2022030906443803412
2022030906443803413
Wessels.
Streptococcal pharyngitis.
N Engl J Med., (2011), 364 pp. 648-655
[6]
A.L. Bisno.
Acute pharyngitis: etiology and diagnosis.
Pediatrics., (1996), 97 pp. 949-954
[7]
S. Nimishikavi, L. Stead.
Images in clinical medicine.
Streptococcal pharyngitis. N Engl J Med., (2005 Mar), 352 pp. e10
[8]
D.K. Yeoh, A.C. Bowen, J.R. Carapetis.
Impetigo and scabies–Disease burden and modern treatment strategies.
J Infect., (2016), 72 pp. S61-S67
[9]
L.B.
2022030906443803414
Pereira.
Impetigo - review.
An Bras Dermatol., (2014), 89 pp. 293-299
[10]
M.S. Simon, R.L. Cody.
Cellulitis after axillary lymph node dissection for carcinoma of the breast.
Am J Med., (1992), 93 pp. 543-548
[11]
D.L.
2022030906443803415
Stevens, M.H. Tanner, J. Winship, R. Swarts, K.M. Ries, P.M. Schlievert, 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 pp. 1-7
[12]
M.J.
2022030906443803416
2022030906443803417
Walker, T.C. Barnett, J.D. McArthur, J.N. Cole, C.M. Gillen, A. Henningham, et al.
Disease manifestations and pathogenic mechanisms of Group A Streptococcus.
Clin Microbiol Rev., (2014), 27 pp. 264-301
[13]
K.
2022030906443803418
Edmond, A. Zaidi.
New approaches to preventing, diagnosing, and treating neonatal sepsis.
PLoS Med., (2010), 7 pp. 1-8
[14]
L.M. Baddour.
Infective endocarditis caused by beta-hemolytic streptococci. the Infectious Diseases Society of America's Emerging Infections Network.
Clin Infect Dis., (1998), 26 pp. 66-71
[15]
S. Chamat-Hedemand, A. Dahl, L. Østergaard, M. Arpi, E. Fosbøl, J. Boel, et al.
Prevalence of Infective Endocarditis in Streptococcal Bloodstream Infections Is Dependent on Streptococcal Species.
Circulation., (2020), 142 pp. 720-730
[16]
L.M.
2022030906443803419
2022030906443803420
Baddour, W.R. Wilson, A.S. Bayer, V.G. Fowler, I.M. Tleyjeh, M.J. Rybak, et al.
Infective endocarditis in adults: diagnosis, antimi-crobial therapy, and management of complications: a scientific statement for healthcare professionals from the American Heart Association.
Circulation., (2015), 132 pp. 1435-1486
[17]
J. Bosch-Mestres, R.M. Martín-Fernández, Mt. Jiménez de Anta-Losada.
Estudio comparativo de tres medios de cultivo para detectar la colonización por estreptococo del grupo B en la mujer embarazada [Comparative study of three culture media for detecting group B Streptococcus colonization in pregnant women].
Enferm Infecc Microbiol Clin., (2003), 21 pp. 346-349
[18]
S. Giuliano, R. Caccese, P. Carfagna, A. Vena, M. Falcone, M. Venditti.
Endocarditis caused by nutritionally variant streptococci: a case report and literature review.
Infez Med., (2012), 20 pp. 67-74
[19]
L. Weinstein, J. Le Frock.
Does antimicrobial therapy of streptococcal pharyngitis or pyoderma alter the risk of glomerulonephritis?.
J Infect Dis., (1971), 124 pp. 229-231
[20]
F.J.
2022030906443803421
Catanzaro, C.A. Stetson, A.J. Morris, R. Chamovitz, C.H. Rammelkamp Jr., B.L. Stolzer, et al.
The role of streptococcus in the pathogenesis of rheumatic fever.
Am J Med., (1954), 17 pp. 749-756
[21]
M.
2022030906443803422
Gerber, R. Baltimore, C. Eaton, M. Gewitz, A.H. Rowley, S.T. Shulman, et al.
Prevention of rheumatic fever and diagnosis and treatment of acute streptococcal pharyngitis: a scientific statement from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young, the Interdisciplinary Council on Functional Genomics and Translational Biology, and the Interdisciplinary Council on Quality of Care and Outcomes Research.
Circulation., (2009), 119 pp. 1541-1550
[22]
L.K. Logan, J.B. McAuley, St. Shulman.
Macrolide treatment failure in streptococcal pharyngitis resulting in acute rheumatic fever.
Pediatrics., (2012), 129 pp. e798-e802
[23]
F.
2022030906443803423
Andreoni, C. Zürcher, A. Tarnutzer, K. Schilcher, A. Neff, N. Keller, et al.
Clindamycin affects group A Streptococcus virulence factors and improves clinical outcome.
J Infect Dis., (2017), 215 pp. 269-277
[24]
J.R.
2022030906443803424
Verani, L. McGee, S.J. Schrag.
Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases C for DC and P (CDC). Prevention of perinatal group B streptococcal disease--revised guidelines from CDC, 2010.
MMWR Recomm Rep., (2010), 59 pp. 1-36
[25]
2022030906443803425
Habib G, Lancellotti PEG for the management of infective endocarditis, Antunes MJ, Bongiorni MG, Casalta JP, Del Zotti F, et al., 2015 ESC Guidelines for the management of infective endocarditis. Eur Heart J. 2015; 36(44):3075-123.
[26]
http://bit.ly/2mX9E9z.