Evidence map›Paper›PMID 40590929›Full record

ArticleInternational journal of legal medicine2025

A case of suspected transmission of group A Streptococcus from a dead body with streptococcal toxic shock syndrome to an autopsy worker.

Keisuke Okaba, Ayumi Motomura, Naoki Saito, Koji Yamaguchi, Namiko Ishii, Shizuru Hara, Misako Ohkusu, Noriko Takeuchi, Naruhiko Ishiwada, Daisuke Yajima

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Article in International journal of legal medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Keisuke OkabaDepartment of Forensic Medicine, School of Medicine, International University of Health and Welfare, Narita, Japan. k.okaba@iuhw.ac.jp.ORCID http://orcid.org/0000-0002-5420-0978
Ayumi MotomuraDepartment of Forensic Medicine, School of Medicine, International University of Health and Welfare, Narita, Japan.
Naoki SaitoDepartment of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan.
Koji YamaguchiDepartment of Forensic Medicine, School of Medicine, International University of Health and Welfare, Narita, Japan.
Namiko IshiiDepartment of Forensic Medicine, School of Medicine, International University of Health and Welfare, Narita, Japan.
Shizuru HaraDepartment of Forensic Medicine, School of Medicine, International University of Health and Welfare, Narita, Japan.
Misako OhkusuDepartment of Infectious Diseases, Medical Mycology Research Center, Chiba University, Chiba, Japan.
Noriko TakeuchiDepartment of Infectious Diseases, Medical Mycology Research Center, Chiba University, Chiba, Japan.
Naruhiko IshiwadaDepartment of Infectious Diseases, Medical Mycology Research Center, Chiba University, Chiba, Japan.
Daisuke YajimaDepartment of Forensic Medicine, School of Medicine, International University of Health and Welfare, Narita, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Autopsy workers are known to be at risk of contracting various infectious diseases from dead bodies. However, infections caused by group A Streptococcus (GAS, Streptococcus pyogenes) are rarely reported and often overlooked despite their potential severity. GAS infections can lead to serious complications, including streptococcal toxic shock syndrome (STSS). In this study, we conducted genetic analyses to identify the source of GAS bacteremia in a worker who conducted an autopsy on an individual who had developed STSS from GAS. GAS strains from the dead body and autopsy worker were analyzed using polymerase chain reaction (PCR) for five major streptococcal pyrogenic exotoxin (SPE) genes (speA, speB, speC, speF, and ssa) and M protein (emm) typing by sequencing. Multilocus sequence typing (MLST) was performed to analyze seven housekeeping genes (gki, gtr, murI, mutS, recP, xpt, and yqiL) by PCR and sequencing. Both GAS strains were positive for speB and speF, negative for speA, speC, and ssa, and classified as emm81.0 and sequence type 117. This is the first report to demonstrate homology between GAS strains from a dead body and autopsy worker using the M-protein type, SPE gene expression, and MLST analysis. Although the autopsy was conducted in a controlled environment with appropriate personal protective equipment, including N95 masks, GAS contact transmission may have occurred during other handling procedures, such body transportation. These findings emphasize the need for stringent precautionary measures when handling dead bodies and their specimens, considering the risk of infection at any time.

Indexed as

Infectious Disease Transmission, Patient-to-ProfessionalShock, SepticStreptococcal InfectionsStreptococcus pyogenesAutopsyExotoxinsHumansMaleMultilocus Sequence TypingPolymerase Chain ReactionExotoxinsAirborne infectionsContact infectionsForensic autopsy; Streptococcus pyogenesGASStreptococcal toxic shock syndrome

Identifiers

PMID40590929

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.