{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T15:49:07Z","timestamp":1785944947122,"version":"3.56.0"},"reference-count":60,"publisher":"American Society for Microbiology","issue":"1","license":[{"start":{"date-parts":[[2008,1,1]],"date-time":"2008-01-01T00:00:00Z","timestamp":1199145600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2008,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Active surveillance of invasive group A streptococcal (GAS) infections was conducted in Denmark during 2003 and 2004 as a part of the Strep-EURO initiative. The main objective was to improve understanding of the epidemiology of invasive GAS disease in Denmark. During the 2 years, 278 cases were reported, corresponding to a mean annual incidence of 2.6 cases per 100,000 inhabitants. The vast majority of isolates, 253 (91%), were from blood, with the remaining 25 (9%) being from cerebrospinal fluid, joints, or other normally sterile sites. The mean case fatality rate (CFR) was 20%, with the rate being higher in patients more than 70 years of age (36.5%). For streptococcal toxic shock syndrome (STSS) and necrotizing fasciitis the CFRs were 53% and 25%, respectively. Out of 16 T types recorded, three predominated: T28 (23%), T1 (22%), and the cluster T3\/13\/B3264 (14%). Among 29 different\n            <jats:italic>emm<\/jats:italic>\n            types,\n            <jats:italic>emm<\/jats:italic>\n            28 and\n            <jats:italic>emm<\/jats:italic>\n            1 accounted for 51% of strains, followed by\n            <jats:italic>emm<\/jats:italic>\n            3 (11%),\n            <jats:italic>emm<\/jats:italic>\n            89 (7%), and\n            <jats:italic>emm<\/jats:italic>\n            12 (5.5%). Low resistance rates were detected for macrolide-lincosamide-streptogramin B (MLS\n            <jats:sub>B<\/jats:sub>\n            ) antibiotics (3%) and tetracycline (8%); two isolates exhibited coresistance to tetracycline and macrolides. Of nine pyrogenic exotoxin (superantigen) genes examined,\n            <jats:italic>speA<\/jats:italic>\n            and\n            <jats:italic>speC<\/jats:italic>\n            were identified in 58% and 40% of the strains, respectively; either of the genes was present in all strains causing STSS. Most strains harbored\n            <jats:italic>speG<\/jats:italic>\n            (99%).\n            <jats:italic>ssa<\/jats:italic>\n            was present in 14% of the isolates only. In Denmark, as in comparable countries, GAS invasive disease shows a sustained, high endemicity, with involvement of both established and emerging streptococcal\n            <jats:italic>emm<\/jats:italic>\n            and T types.\n          <\/jats:p>","DOI":"10.1128\/jcm.01626-07","type":"journal-article","created":{"date-parts":[[2007,10,24]],"date-time":"2007-10-24T23:12:03Z","timestamp":1193267523000},"page":"79-86","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":96,"title":["Clinical and Epidemiological Aspects of Invasive\n            <i>Streptococcus pyogenes<\/i>\n            Infections in Denmark during 2003 and 2004"],"prefix":"10.1128","volume":"46","author":[{"given":"Bogdan","family":"Luca-Harari","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology, Institute of Laboratory Medicine, Lund University, Lund, 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