{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T13:38:08Z","timestamp":1774013888571,"version":"3.50.1"},"reference-count":30,"publisher":"American Society for Microbiology","issue":"5","license":[{"start":{"date-parts":[[2012,5,1]],"date-time":"2012-05-01T00:00:00Z","timestamp":1335830400000},"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":[[2012,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            The lack of epidemiologic data on invasive\n            <jats:named-content content-type=\"genus-species\">Streptococcus pyogen<\/jats:named-content>\n            es infections in many developing countries is concerning, as\n            <jats:named-content content-type=\"genus-species\">S. pyogenes<\/jats:named-content>\n            infections are commonly endemic in these areas. Here we present the results of the first prospective surveillance study of invasive\n            <jats:named-content content-type=\"genus-species\">Streptococcus pyogenes<\/jats:named-content>\n            infections in India. Fifty-four patients with invasive\n            <jats:named-content content-type=\"genus-species\">S. pyogenes<\/jats:named-content>\n            infections were prospectively enrolled at two study sites, one in the north and one in the south of India. Sterile-site isolates were collected, and clinical information was documented using a standardized questionnaire. Available acute-phase sera were tested for their ability to inhibit superantigens produced by the patient's own isolate using a cell-based neutralizing assay. The most common clinical presentations were bacteremia without focus (30%), pneumonia (28%), and cellulitis (17%). Only two cases of streptococcal toxic shock syndrome and no cases of necrotizing fasciitis were identified. Characterization of the isolates revealed great heterogeneity, with 32 different\n            <jats:italic>emm<\/jats:italic>\n            subtypes and 29 different superantigen gene profiles being represented among the 49 sterile-site isolates. Analyses of acute-phase sera showed that only 20% of the cases in the north cohort had superantigen-neutralizing activity in their sera, whereas 50% of the cases from the south site had neutralizing activity. The results demonstrate that there are important differences in both clinical presentation and strain characteristics between invasive\n            <jats:named-content content-type=\"genus-species\">S. pyogenes<\/jats:named-content>\n            infections in India and invasive\n            <jats:named-content content-type=\"genus-species\">S. pyogenes<\/jats:named-content>\n            infections in Western countries. The findings underscore the importance of epidemiologic studies on streptococcal infections in India and have direct implications for current vaccine developments.\n          <\/jats:p>","DOI":"10.1128\/jcm.06697-11","type":"journal-article","created":{"date-parts":[[2012,2,23]],"date-time":"2012-02-23T01:41:32Z","timestamp":1329961292000},"page":"1626-1631","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":22,"title":["Clinical and Microbiologic Characteristics of Invasive Streptococcus pyogenes Infections in North and South India"],"prefix":"10.1128","volume":"50","author":[{"given":"Axana","family":"Haggar","sequence":"first","affiliation":[{"name":"Center for Infectious Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Nerlich","sequence":"additional","affiliation":[{"name":"Helmholtz Centre for Infection Research, Braunschweig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajesh","family":"Kumar","sequence":"additional","affiliation":[{"name":"School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vinod J.","family":"Abraham","sequence":"additional","affiliation":[{"name":"Department of Community Health, Christian Medical College, Vellore, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kootallur N.","family":"Brahmadathan","sequence":"additional","affiliation":[{"name":"Department of Microbiology Christian Medical College, Vellore, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pallab","family":"Ray","sequence":"additional","affiliation":[{"name":"School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanita","family":"Dhanda","sequence":"additional","affiliation":[{"name":"School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John Melbin Jose","family":"Joshua","sequence":"additional","affiliation":[{"name":"Department of Microbiology Christian Medical College, Vellore, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Narinder","family":"Mehra","sequence":"additional","affiliation":[{"name":"Department of Transplant Immunology and Immunogenetics, All Indian Institute of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rene","family":"Bergmann","sequence":"additional","affiliation":[{"name":"Helmholtz Centre for Infection Research, Braunschweig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G. Singh","family":"Chhatwal","sequence":"additional","affiliation":[{"name":"Helmholtz Centre for Infection Research, Braunschweig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Norrby-Teglund","sequence":"additional","affiliation":[{"name":"Center for Infectious Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"235","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid1410.071660"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/IAI.67.4.1871-1877.1999"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/173.4.896"},{"key":"e_1_3_3_5_2","first-page":"306","article-title":"Epidemiology of streptococcal pyoderma in an orphanage community of a tropical country","volume":"91","author":"Brahmadathan KN","year":"1988","unstructured":"BrahmadathanKN KoshiG. 1988. Epidemiology of streptococcal pyoderma in an orphanage community of a tropical country. J. Trop. Med. Hyg. 91:306\u2013314.","journal-title":"J. Trop. Med. Hyg."},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(05)70267-X"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2011.09.005"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1086\/376630"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199608223350803"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/45.suppl_1.3"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2005.01169.x"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid1101.030651"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3156.2010.02670.x"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1086\/515199"},{"key":"e_1_3_3_15_2","first-page":"765","article-title":"Epidemiology of group A streptococcal pharyngitis & impetigo: a cross-sectional & follow up study in a rural community of northern India","volume":"130","author":"Kumar R","year":"2009","unstructured":"KumarR. 2009. Epidemiology of group A streptococcal pharyngitis & impetigo: a cross-sectional & follow up study in a rural community of northern India. Indian J. Med. Res. 130:765\u2013771.","journal-title":"Indian J. Med. 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Rheumatic fever and rheumatic heart disease in India at the turn of the century. Indian Heart J. 53:35\u201337.","journal-title":"Indian Heart J."},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2180-8-150"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02725655"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid15\/2.080558"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(09)70178-1"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.3109\/00365540903179749"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1993.03500030088038"}],"container-title":["Journal of Clinical Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/JCM.06697-11","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/JCM.06697-11","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,5]],"date-time":"2022-03-05T11:20:13Z","timestamp":1646479213000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/JCM.06697-11"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,5]]},"references-count":30,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2012,5]]}},"alternative-id":["10.1128\/JCM.06697-11"],"URL":"https:\/\/doi.org\/10.1128\/jcm.06697-11","relation":{},"ISSN":["0095-1137","1098-660X"],"issn-type":[{"value":"0095-1137","type":"print"},{"value":"1098-660X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,5]]},"assertion":[{"value":"2011-12-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2012-02-16","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2012-04-13","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}