ABSTRACT
Two clusters of necrotizing fasciitis (NF) due to group A streptococcus (GAS) were identified on the Hawaiian islands of Kauai and Maui during 1997 and 2002, respectively. The emm gene sequence types and the pulsed-field gel electrophoresis patterns were determined for 6 isolates recovered from patients with NF and for 116 isolates recovered from patients with temporally associated community-acquired GAS infection. No predominant emm type was identified, and the emm types of 64 (52.5%) of the isolates were considered to be uncommon in the continental United States. These findings suggest that unusual emm types might be responsible for invasive GAS infections in patients from Hawaii.
Subject(s)
Fasciitis, Necrotizing/epidemiology , Fasciitis, Necrotizing/microbiology , Molecular Epidemiology , Streptococcus pyogenes/genetics , Adult , Aged , Bacteremia/epidemiology , Bacteremia/microbiology , Bacterial Proteins/genetics , Cellulitis/epidemiology , Cellulitis/microbiology , Female , Hawaii/epidemiology , Humans , Male , Risk FactorsABSTRACT
A community cluster of severe group A streptococcal skin infections occurred in Maui, Hawaii with 3 fatal cases of necrotizing fasciitis in 2002. emm types 1, 12, 58, 74, 85 and 109 were identified from 8 patients. emm types 74 and 109 have not been previously described in the United States according to the Centers for Disease Control and Prevention database. The identification of uncommon emm types suggested that group A streptococcal sero-types in Hawaii are different from those in the continental United States and can result in serious disease.
