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Review

Human Streptococcus suis Infections in Thailand: Epidemiology, Clinical Features, Genotypes, and Susceptibility

by
Anusak Kerdsin
Faculty of Public Health, Kasetsart University, Chalermphrakiat Sakon Nakhon Province Campus, Sakon Nakhon 47000, Thailand
Trop. Med. Infect. Dis. 2022, 7(11), 359; https://doi.org/10.3390/tropicalmed7110359
Submission received: 17 October 2022 / Revised: 4 November 2022 / Accepted: 7 November 2022 / Published: 8 November 2022
(This article belongs to the Special Issue 10th Anniversary of the Faculty of Public Health, Kasetsart University: Epidemiology, Diagnosis, Pathogenesis, and Public Health Response for Emerging and Re-emerging Tropical Infectious Diseases)
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Abstract

:
Streptococcus suis is a zoonotic pathogen causing substantial economic losses to the pig industry, as well as being a human health burden due to infections worldwide, especially in Southeast Asia. In Thailand, there was high cumulative incidence in humans during 1987–2021, mostly in males. At least five large outbreaks have been documented after the largest outbreak in China in 2005, which was related to the consumption of raw pork or dishes containing pig’s blood. The major clinical features are sepsis or meningitis, with hearing loss a major complication of S. suis disease. Thai human S. suis isolates have shown diversity in serotypes and sequence types (STs), with serotype 2 and STs 1 and 104 being major genotypes. β-Lactam antibiotics can be used in empirical treatment for human S. suis infections; however, intermediate resistance to penicillin has been reported. Reducing S. suis incidence in Thailand requires a multidimensional approach, with combined efforts from the government and public health sectors through policy, regulations, education, and active surveillance.

1. Introduction

Streptococcus suis is a Gram-positive coccus bacterium responsible for major infections in pigs and significant economic losses in the pig industry worldwide. The most important clinical manifestations associated with S. suis infection in pigs are meningitis, arthritis, endocarditis, pneumonia, rhinitis, abortion, and vaginitis [1]. It is also an emerging zoonotic pathogen causing serious diseases in humans, including meningitis, sepsis, septic shock, infective endocarditis, and septic arthritis [1,2]. The number of reported human S. suis cases has substantially increased, with Southeast Asian countries leading the counts, especially Thailand and Vietnam [1,2,3]. Occupations related to pigs or pork, exposure to pig or pork products, or the consumption of raw pork products are the main risk factors of human infection [1,3].
S. suis is an encapsulated pathogen, with the capsular polysaccharide antigens being the basis for classification into serotypes [1]. Among 29 serotypes, serotype 2 is considered the most pathogenic and a frequent cause of human disease worldwide [1]. In Western countries, such as the United Kingdom, Spain, Germany, the Netherlands, Canada, and the United States, as well as in Japan, China, and Hong Kong, most human S. suis cases have occurred after occupational exposure involving pig handling among pig farmers, bleeders, abattoir workers, carcass cutting and processing workers, butchers, and cooks [3]. However, in Southeast Asian countries, such as Thailand, Vietnam, and Indonesia, a nontrivial number of human cases has occurred in individuals consuming meals containing raw pork meat, blood, and other related products [3]. Two studies in Thailand showed that S. suis human infections were responsible for an estimated loss in productivity-adjusted life years to the gross domestic product of USD11.3 million, which equates to USD36,033 lost per person and out-of-pocket expenses for individuals and their families that averaged USD140 (GBP104 or THB5198) per patient [4,5].
In this review, we focus on S. suis infections in Thai humans based on epidemiology, clinical manifestations, genotypes, and susceptibility to antimicrobials. Thailand’s high incidence of human S. suis cases can provide information for policy implementation, active surveillance, and prevention of this disease.

2. Epidemiology of Human S. suis Infections in Thailand

In Thailand, S. suis infection was first described in 1987 in Bangkok, with two cases of meningitis [6]. Before the largest outbreak of human S. suis infection occurred in Sichuan province, China in 2005 [7], sporadic human cases had been reported in several provinces in Thailand, especially in the north [8,9,10,11,12,13,14]. One outbreak with 10 fatal cases due to septic shock was documented in 2000 in Lamphun province, northern Thailand, well before the largest outbreak occurred in China [14]. That study demonstrated that all cases were healthy men aged 40–49 years who were clustered during the same period and geographic area [14]. All cases had a history of chronic alcohol use and the consumption of raw pork or pig’s blood dishes prior to their illness [14]. Notably, all cases in that study had clinical symptoms similar to the cases in the Sichuan outbreak in China in 2005 [7,14].
After the Sichuan outbreak in China, the importance of this disease has been increasingly recognized in Thailand, as well as in many countries worldwide. Up to the present, five large outbreaks of S. suis infections in humans have been documented in Thailand: four of these outbreaks were in the north, whereas a fifth outbreak occurred in the northeast. The first outbreak, comprising 29 laboratory-confirmed cases and 3 deaths, occurred in Phayao province during May 2007 [15]. A second outbreak was recognized in Chiang Mai and Lamphun provinces during June–July 2008, with 44 confirmed cases, 26 suspected cases, and 3 fatal cases with septic shock [16]. The third outbreak was reported in Phetchabun province in April 2010, with 14 confirmed cases, of which 5 were fatal [2]. The fourth outbreak was reported in Uttaradit province in May 2019, with 5 confirmed cases and 18 suspected cases [17]. A fifth outbreak occurred for the first time in northeastern Thailand (Nakhon Ratchasima) in 2021, with 21 confirmed cases, including 2 fatal cases [18]. Microbiological analysis of the outbreak S. suis strains showed that the first and second outbreaks were due to serotype 2 with sequence type (ST) 1, while the third outbreak was caused by serotype 2-ST104 and serotype 14-ST105. There was no available information about the serotype and STs in the fourth outbreak. The fifth outbreak was caused by serotype 2 with a new ST (ST1656) belonging to the clonal complex (CC) 233/379 [18].
National guidelines for human S. suis infections are not yet available in Thailand. However, the practice of S. suis recruitment in the public health system is conducted using the R506 system (a daily case report of communicable diseases) of the Ministry of Public Health that was initiated after the first large outbreak in 2007. As shown in Figure 1, human cases reported in the system showed an increasing trend during 2011–2021. Although the number of cases dropped in 2022, annual data were only up until September. Notably, these reported cases were submitted by the hospital network where they could identify this bacterium. Thus, misidentification of S. suis as other bacteria might have occurred, and this would not have been reported in that system [19,20,21,22]. Therefore, the reported human S. suis cases registered in the R506 system may be lower than the real situation.
The national annual crude incidence is 0–0.381 per 100,000 persons [22]. A study in Nakhon Phanom province (northeastern Thailand) documented an annual incidence of 0.1–2.2 cases per 100,000 population for 2006–2012 [22]. This differed from a study in 2010 that estimated human cases to be 730 per year in northern Thailand, with an incidence of 6.2 per 100,000 of the general population [23]. The reasons for these different rates are still unknown, but ethnicity, tribe, cultural behavior, and lifestyle might all influence the S. suis infection rate [3].
Three retrospective studies reported that the incidence of S. suis disease was high during the rainy season (June–September) [24,25,26]. In contrast, a prospective study in Phayao province, Thailand showed peak incidence in summer (April and May) [23]. In addition, all five outbreaks discussed above occurred in summer. Almost all cases were related to the Songkran Festival (a traditional Thai New Year festival in Thailand) and other harvesting festivals during summer [3].
Several studies revealed that adult age, male sex, alcohol drinking, pig-related occupation or exposure, and raw pork consumption were common risk factors of S. suis infections in Thailand [15,27,28]. However, two meningitis cases in children caused by S. suis have also been reported in this country [9,29]. The first case was infected with an unknown serotype and ST and the second case was caused by serotype 24 with ST221 [9,29]. Overall, mortality of S. suis infections in Thailand is in the range 9.5–19.5% [4,13,24,25,26,30]. Several studies in Thailand have shown that fatal risk factors include septic shock, rapid onset of illness, prolonged bacteremia ≥ 6 days, low serum albumin, high serum total bilirubin, low platelet count, and elevated alanine transaminase [13,26,30]. In particular, septic shock is a strong risk factor, being 22-folds greater than in non-septic shock patients [30].

3. Clinical Features of Thai Human S. suis Infections

This review collected all reported papers written in either Thai or English that documented S. suis infections in Thailand from the available online databases (PubMed, ScienceDirect, Scopus, Google, Thai Index Medicus of Chulalongkorn University, and Siriraj Hospital, Bureau of Epidemiology). Search terms were S. suis, human, clinical, Thai, Thailand, outbreak, all years.
In total, 1798 cases from 59 reports were identified [6,8,9,10,11,12,13,14,15,16,17,18,21,22,23,24,25,26,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68]. Most cases were male (n = 1287). Among the 1798 cases, 1052 involved consumption and/or exposure to pig or raw pork products. Septicemia and meningitis were predominant clinical manifestations and hearing loss was a major complication. All this information is summarized in Table 1. According to the retrospective and prospective studies, septicemia/sepsis and meningitis were the most common clinical features found in Thai patients [23,24,25,26].

4. Genotypes of Thai Human S. suis Strains

As shown in Table 2, for S. suis isolated from patients in Thailand, serotype 2 (93.4%) was dominant, followed by serotypes 14 (5.2%), 24 (0.6%), 5 (0.4%), 4 (0.1%), 9 (0.1%), 31 (0.1%), and unencapsulated (0.1%), respectively [21,24,25,32,69]. MLST classified serotype 2 into five CCs: CC1, CC25, CC28, CC104, and CC233/379. Of these, CC1 is a major CC of human S. suis infection in this country and ST1 is the main ST in CC1 [25], while serotype 14 was classified to only CC1, with ST105 predominant [25,69]. For serotype 2, ST104, ST25, ST28, and ST233 were the main STs in CC104, CC25, CC28, and CC233/379, respectively. Notably, STs 1 and 104 for serotype 2 are the predominant STs in Thai human infections, and CC104, CC233/379, and CC221/234 are found exclusively in Thailand [24,25,70].
Two retrospective studies revealed that the ST1 strains were more associated with meningitis than the other STs [24,25]. However, the ST104 strains were more associated with non-meningitis, especially sepsis [24]. Differences in clinical manifestations caused by either ST1 or ST104 may have been influenced by genetic backgrounds. Genomic comparison between ST1 and ST104 strains identified that salK/salR, the srtBCD gene cluster, revS, rgg, epf, and a putative virulence factor SSU0835 (an ABC-type multidrug transport system), with the latter described as being involved in the invasion of porcine brain microvascular endothelial cells, were absent in ST104 [71]. Another study showed ST104 strains failed to develop high levels of meningitis in a mouse model due to low or no production of suilysin by a negligible level of transcription of the sly gene and undetectable sly promoter activities [72]. That study also illustrated the contribution of suilysin to the development of meningitis by ST1 [72]. These results may explain why ST104 caused less meningitis than sepsis.
Although most cases of Thai human S. suis infections had a history of consumption of raw pork dishes, there was no direct evidence or laboratory investigation to confirm or prove the S. suis strains in the raw pork dishes that were eaten because none of the raw pork dishes remained after consumption. Indirect investigation was conducted with S. suis isolated from slaughterhouse pigs. Three studies showed S. suis strains isolated from pigs in Thailand had genotypic profiles of PFGE, RAPD, MLST or combined techniques identical to the S. suis strains from humans [73,74,75]. For example, Kerdsin and colleagues (2020) demonstrated that 70.4% of isolates of S. suis serotypes 2 and 14 from slaughterhouse pigs revealed STs and PFGE patterns identical to the human isolates [73]. Similarly to Maneerat et al. (2013), the finding showed most of S. suis serotype 2 isolates collected from human patients and pigs (diseased and asymptomatic) in different regions of Thailand had the same of ST, RAPD, and virulence-associated gene profile [74], Such indirect evidence suggests the genetic relationships and confirms the possibility of zoonotic transmission of S. suis isolates from pigs to humans for certain STs, especially ST1 and ST104, as well as proving that slaughterhouse pigs are a reservoir of pathogenic human S. suis strains.

5. Antimicrobial Susceptibility

Other studies have revealed that Thai S. suis isolates were susceptible to penicillin [13]. This contrasted with Nakaranurack et al. (2017), who reported that 6 out of 11 Thai S. suis isolates were intermediately resistance to penicillin, whereas cefotaxime and vancomycin were completely susceptible [35]. However, a study in 2021 demonstrated that 448 S. suis isolates recovered from human infections in Thailand had 8.2% intermediate resistance to penicillin, while they were all susceptible to cefepime and ceftriaxone [76]. One study revealed penicillin-resistant S. suis with a high minimal inhibitory concentration (MIC) value of >32 μg/mL [77]. Most of the intermediately penicillin-resistant isolates belonged to serotype 2-ST233 [76]. This contrasted with worldwide human S. suis isolates showing susceptibility to β-lactam antibiotics, including penicillin, ampicillin, amoxicillin, cefotaxime, ceftriaxone, cefepime, meropenem, and imipenem [78,79,80,81,82]. Although there is worldwide usage of β-lactams in pigs and humans, almost all human S. suis isolates remain susceptible to this antimicrobial class.
Resistance to tetracycline (98.2%), clindamycin (94%), erythromycin (92.4%), and azithromycin (82.6%) with the resistance genes tet(O) and ermB were the predominant determinant genes of tetracycline and erythromycin (also macrolide-lincosamide–streptogramin B (MLSB)) resistance detected in 448 S. suis isolates [76]. Resistance to tetracycline appeared common in S. suis from human infections worldwide [78,79,80,81,82], whereas the resistance rates to erythromycin were low in Poland, Hong Kong, and Vietnam [78,79,83]. Although tet(O) is prevalent in human S. suis in Thailand, the tet(M) gene is the most widespread in human S. suis in China and Vietnam [79,81]. The ermB gene was predominant in human isolates in Vietnam and Thailand, while mefA was present in Hong Kong [76,79]. This may indicate differences in the local spread of tetracycline and erythromycin-resistance genes among human S. suis isolates in different countries or geographical regions.
A recent study investigated an emerging S. suis ST1656 belonging to CC233/379 that caused the fifth outbreak in Thailand carried the MLSB resistance gene ermA and the oxazolidinone and phenicol resistance gene optrA that were found exclusively in the outbreak isolates other than tet(O) and ermB [18].

6. Public Health Control

Kerdsin et al. (2022) mentioned that sociocultural factors, including cultural, religious, and societal behaviors and attitudes associated with the consumption of raw pork or pig’s blood play an important role in human infections [3]. Therefore, effecting a reduction in the human S. suis cases in Thailand requires a multidimensional approach involving the government and community sectors. Enforcement is required of meat inspection regulations and hygiene practices at pork processing facilities, as well as conducting food safety campaigns, establishing an educational program on preventing this infection, and reducing behavior regarding the consumption of raw pork or pig’s blood dishes.
Another study in Thailand showed the effectiveness of a food safety campaign [42]. Overall, this campaign led to a marked decrease in the annualized incidence of human S. suis disease, from 6.4/100,000 persons in 2010 (before the campaign implementation) to 2.7/100,000 persons in 2011, then to 2.0/100,000 persons in 2012, and finally to 3.5/100,000 persons in 2013 [42]. Finally, early diagnostics in S. suis suspected patients using rapid alternative methods rather than traditional culture (a gold standard but slower) could facilitate prompt treatment and reduce the mortality rate, as well as prompt epidemiological investigation [84,85,86,87].

7. Conclusions and Perspectives

Thailand has the second-highest number of reported human S. suis cases, accounting for 11% of all reported cases worldwide [88]. S. suis infections in Thailand had a very high cumulative incidence during 1987–2021, with males being represented in most cases due to them more commonly consuming raw pork or pig’s blood dishes than females. The consumption of raw pork/pig’s blood dishes is common in Thailand, especially in the north. At least five large outbreaks have been documented in Thailand along with the largest reported outbreak in Sichuan, China in 2005, and have been related to the consumption of raw pork/pig’s blood dishes. However, the first large outbreak in Thailand was apparently in 2000. The most common clinical features are sepsis or meningitis, while hearing loss is a major complication of S. suis disease.
Thai human S. suis isolates have diversified in serotypes and STs, with serotype 2 and STs 1 and 104 being the majority in Thailand. In addition, serotype 14 with ST105 is also prevalent in the country. β-Lactam antibiotics can be used in empirical treatment for human S. suis infections; however, intermediate resistance to penicillin has been reported. This should be of concern and should be carefully monitored. Thai S. suis strains have been reported to be highly resistant to macrolide and tetracycline.
Reducing human S. suis disease is Thailand requires a multidimensional approach combining government and public health efforts through policy, regulations, and education, and active community involvement to effect behavioral changes that are evidence-based but culturally sensible and acceptable, along with the implementation in health-care systems of more rapid diagnostics and more relevant screening tools. Most hospital laboratories in Thailand are not able to confirm S. suis, and consequently the infection might be misdiagnosed. Improving the capacity of hospital laboratories to identify S. suis will aid clinical management, facilitate outbreak detection and response, and facilitate the swift initiation of control measures.

Funding

This research received no external funding.

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Not applicable.

Data Availability Statement

Not applicable.

Acknowledgments

The Kasetsart University Research and Development Institute (KURDI), Bangkok, Thailand provided English-editing assistance.

Conflicts of Interest

The authors declare no conflict of interest.

References

  1. Goyette-Desjardins, G.; Auger, J.P.; Xu, J.; Segura, M.; Gottschalk, M. Streptococcus suis, an important pig pathogen and emerging zoonotic agent-an update on the worldwide distribution based on serotyping and sequence typing. Emerg. Microbes. Infect. 2014, 3, e45. [Google Scholar] [CrossRef] [PubMed]
  2. Segura, M.; Aragon, V.; Brockmeier, S.L.; Gebhart, C.; De Greeff, A.; Kerdsin, A.; O’Dea, M.A.; Okura, M.; Saléry, M.; Schultsz, C.; et al. Update on Streptococcus suis Research and Prevention in the Era of Antimicrobial Restriction: 4th International Workshop on S. suis. Pathogens 2020, 9, 374. [Google Scholar] [CrossRef] [PubMed]
  3. Kerdsin, A.; Segura, M.; Fittipaldi, N.; Gottschalk, M. Sociocultural Factors Influencing Human Streptococcus suis Disease in Southeast Asia. Foods 2022, 11, 1190. [Google Scholar] [CrossRef]
  4. Thongsawad, S. Burden and Epidemiological Characterisations of Streptococcus suis in Chiang Mai, Thailand. Ph.D. Thesis, The University of Edinburgh, Edinburgh, UK, 2016. [Google Scholar]
  5. Rayanakorn, A.; Ademi, Z.; Liew, D.; Lee, L.-H. Burden of disease and productivity impact of Streptococcus suis infection in Thailand. PLoS Negl. Trop. Dis. 2021, 15, e0008985. [Google Scholar] [CrossRef] [PubMed]
  6. Phuapradit, P.; Boongird, P.; Boonyakarnkul, S.; Niramarnsakul, S.; Ponglikitmongkol, S.; Vorachit, M. Meningitis caused by Streptococcus suis in humans. Intern. Med. 1987, 3, 120–122. [Google Scholar]
  7. Yu, H.; Jing, H.; Chen, Z.; Zheng, H.; Zhu, X.; Wang, H.; Wang, S.; Liu, L.; Zu, R.; Luo, L.; et al. Streptococcus suis study groups. Human Streptococcus suis outbreak, Sichuan, China. Emerg. Infect. Dis. 2006, 12, 914–920. [Google Scholar] [CrossRef]
  8. Teekakirikul, P.; Wiwanitkit, V. Streptococcus suis infection: Overview of case reports in Thailand. S. Asian J. Trop. Med. Public Health 2003, 34 (Suppl. 2), 178–183. [Google Scholar]
  9. Vilaichone, R.K.; Vilaichone, W.; Nunthapisud, P.; Wilde, H. Streptococcus suis infection in Thailand. J. Med. Assoc. Thai. 2002, 85 (Suppl. 1), S109–S117. [Google Scholar]
  10. Donsakul, K.; Dejthevaporn, C.; Witoonpanich, R. Streptococcus suis infection: Clinical features and diagnostic pitfalls. S. Asian J. Trop. Med. Public Health 2003, 34, 154–158. [Google Scholar]
  11. Suankratay, C.; Intalapaporn, P.; Nunthapisud, P.; Arunyingmongkol, K.; Wilde, H. Streptococcus suis meningitis in Thailand. S. Asian J. Trop. Med. Public Health 2004, 35, 868–876. [Google Scholar]
  12. Rusmeechan, S.; Sribusara, P. Streptococcus suis meningitis: The newest serious infectious disease. J. Med. Assoc. Thail. 2008, 91, 654–658. [Google Scholar]
  13. Wangkaew, S.; Chaiwarith, R.; Tharavichitkul, P.; Supparatpinyo, K. Streptococcus suis infection: A series of 41 cases from Chiang Mai University Hospital. J. Infect. 2006, 52, 455–460. [Google Scholar] [CrossRef] [PubMed]
  14. Fongcom, A.; Pruksakorn, S.; Mongkol, R.; Tharavichitkul, P.; Yoonim, N. Streptococcus suis infection in northern Thailand. J. Med. Assoc. Thail. 2001, 84, 1502–1508. [Google Scholar]
  15. Khadthasrima, N.; Hannwong, T.; Thammawitjaya, P.; Pingsusean, D.; Akkanij, B.; Jaikhar, A.; Paungmali, P.; Yudee, P.; Wongyai, S.; Samerchea, S.; et al. Human Streptococcus suis outbreak in Phayao Province, Thailand, 2007. OSIR J. 2008, 1, 4–7. [Google Scholar]
  16. Wongsawat, S. Streptococcus suis serotype 2 outbreak at Chomthong district, Chiang Mai province, June–July, 2008. Lanna Public Health J. 2010, 6, 322–336. [Google Scholar]
  17. Rittisorn, J.; Supaluck, P.; Lohitpintu, S. Investigation of Streptococcus suis outbreak in soldier during joint training, 2–16 April 2019. In Report of Outbreak Investigation; Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health: Nonthaburi, Thailand, 2019. [Google Scholar]
  18. Brizuela, J.; Kajeekul, R.; Roodsant, T.; Riwload, A.; Boueroy, P.; Thaipadungpanit, J.; Jenjaroenpun, P.; Wongsurawat, T.; Batty, E.; van der Putten, B.; et al. Streptococcus suis outbreak in Thailand caused by an emerging zoonotic strain with acquired multidrug resistance. Microb. Genom. 2022; accepted. [Google Scholar]
  19. Le, H.T.T.; Sugiyama, N.; Duangsonk, K.; Tharavichitkul, P.; Osawa, R. Phenotypic and PCR-based identification of bacterial strains isolated from patients with suspected Streptococcus suis infection in northern Thailand. Jpn. J. Infect. Dis. 2012, 65, 171–174. [Google Scholar]
  20. Tarini, N.M.A.; Setiabudy, M.; Susilawathi, N.; Fatmawati, N.; Mayura, I.; Darwinata, E.; Sudiariani, N. Misidentification of S. suis as a Zoonotic Agent. Open Access Maced. J. Med. Sci. 2019, 7, 2309–2312. [Google Scholar] [CrossRef] [Green Version]
  21. Hatrongjit, R.; Kerdsin, A.; Gottschalk, M.; Takeuchi, D.; Hamada, S.; Oishi, K.; Akeda, Y. First human case report of sepsis due to infection with Streptococcus suis serotype 31 in Thailand. BMC Infect. Dis. 2015, 15, 392. [Google Scholar] [CrossRef]
  22. Prapasiri, P.; Owusu, J.T.; Thammathitiwat, S.; Ditsungnoen, D.; Boonmongkon, P.; Sangwichian, O.; Prasert, K.; Srihapanya, S.; Sornwong, K.; Kerdsin, A.; et al. Streptococcus suis Infection in Hospitalized Patients, Nakhon Phanom Province, Thailand. Emerg. Infect. Dis. 2015, 21, 345–348. [Google Scholar] [CrossRef] [Green Version]
  23. Takeuchi, D.; Kerdsin, A.; Pienpringam, A.; Loetthong, P.; Samerchea, S.; Luangsuk, P.; Khamisara, K.; Wongwan, N.; Areeratana, P.; Chiranairadul, P.; et al. Population-Based Study of Streptococcus suis Infection in Humans in Phayao Province in Northern Thailand. PLoS ONE 2012, 7, e31265. [Google Scholar] [CrossRef]
  24. Kerdsin, A.; Dejsirilert, S.; Puangpatra, P.; Sripakdee, S.; Chumla, K.; Boonkerd, N.; Polwichai, P.; Tanimura, S.; Takeuchi, D.; Nakayama, T.; et al. Genotypic Profile of Streptococcus suis Serotype 2 and Clinical Features of Infection in Humans, Thailand. Emerg. Infect. Dis. 2011, 17, 835–842. [Google Scholar] [CrossRef] [PubMed]
  25. Kerdsin, A.; Akeda, Y.; Takeuchi, D.; Dejsirilert, S.; Gottschalk, M.; Oishi, K. Genotypic diversity of Streptococcus suis strains isolated from humans in Thailand. Eur. J. Clin. Microbiol. Infect. Dis. 2018, 37, 917–925. [Google Scholar] [CrossRef] [PubMed]
  26. Rayanakorn, A.; Katip, W.; Goh, B.H.; Oberdorfer, P.; Lee, L.H. Clinical Manifestations and Risk Factors of Streptococcus suis Mortality Among Northern Thai Population: Retrospective 13-Year Cohort Study. Infect. Drug Resist. 2019, 12, 3955–3965. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  27. Rayanakorn, A.; Goh, B.H.; Lee, L.-H.; Khan, T.M.; Saokaew, S. Risk factors for Streptococcus suis infection: A systematic review and meta-analysis. Sci. Rep. 2018, 8, 13358. [Google Scholar] [CrossRef] [Green Version]
  28. Mingkwan, W. Clinical characteristics and the predicting factor of septic shock caused by Streptococcus suis serotype 2 infection, Uttaradit hospital. Uttaradit Hosp. Med. Bull. 2011, 26, 11–24. [Google Scholar]
  29. Kerdsin, A.; Gottschalk, M.; Hatrongjit, R.; Hamada, S.; Akeda, Y.; Oishi, K. Fatal Septic Meningitis in Child Caused by Streptococcus suis Serotype 24. Emerg. Infect. Dis. 2016, 22, 1519–1520. [Google Scholar] [CrossRef] [Green Version]
  30. Wangsomboonsiri, W.; Luksananun, T.; Saksornchai, S.; Ketwong, K.; Sungkanuparph, S. Streptococcus suis infection and risk factors for mortality. J. Infect. 2008, 57, 392–396. [Google Scholar] [CrossRef]
  31. Pumprueng, S. Streptococcus suis meningitis: A case report. Siriraj Hosp. Gaz. 1999, 51, 45–48. [Google Scholar]
  32. Takamatsu, D.; Wongsawan, K.; Osaki, M.; Nishino, H.; Ishiji, T.; Tharavichitkul, P.; Khantawa, B.; Fongcom, A.; Takai, S.; Sekizaki, T. Streptococcus suis in humans, Thailand. Emerg. Infect. Dis. 2008, 14, 181–183. [Google Scholar] [CrossRef]
  33. Fongcom, A.; Pruksakorn, S.; Netsirisawan, P.; Pongprasert, R.; Onsibud, P. Streptococcus suis infection: A prospective study in northern Thailand. S. Asian J. Trop. Med. Public Health 2009, 40, 511–517. [Google Scholar]
  34. Boonyagars, L.; Chongtrakool, P.; Watcharanan, S.P. Meningitis and spondylodiscitis due to Streptococcus suis. J. Infect. Dis. Antimicrob. Agents. 2010, 27, 129–133. [Google Scholar]
  35. Nakaranurack, C.; Puttilerpong, C.; Suwanpimolkul, G. A Decennium of Etiology and Antimicrobial Susceptibility Patterns in Patients with Infective Endocarditis at a University Hospital, Thailand. Jpn. J. Infect. Dis. 2017, 70, 295–300. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  36. Kerdsin, A.; Dejsirilert, S.; Sawanpanyalert, P.; Boonnark, A.; Noithachang, W.; Sriyakum, D.; Simkum, S.; Chokngam, S.; Gottschalk, M.; Akeda, Y.; et al. Sepsis and spontaneous bacterial peritonitis in Thailand. Lancet 2011, 378, 960. [Google Scholar] [CrossRef]
  37. Kerdsin, A.; Takeuchi, D.; Gottschalk, M.; Hamada, S.; Akeda, Y.; Oishi, K. A human case of Streptococcus suis infection caused by an unencapsulated strain. JMM Case Rep. 2014, 1, e002329. [Google Scholar] [CrossRef]
  38. Kerdsin, A.; Hatrongjit, R.; Gottschalk, M.; Takeuchi, D.; Hamada, S.; Akeda, Y.; Oishi, K. Emergence of Streptococcus suis serotype 9 infection in humans. J. Microbiol. Immunol. Infect. 2017, 50, 545–546. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  39. Pachirat, O.; Taksinachanekit, S.; Mootsikapun, P.; Kerdsin, A. Human Streptococcus suis Endocarditis: Echocardiographic Features and Clinical Outcome. Clin. Med. Insights Cardiol. 2012, 6, 119–123. [Google Scholar] [CrossRef] [PubMed]
  40. Thayawiwat, C.; Wichaikham, O.; Painpringam, A. Epidemiology of Streptococcus suis infections: Patients of Chiang Kham hospital, 2009-2011. J. Health Sci. 2012, 21, 575–588. [Google Scholar]
  41. Rusmeechan, S.; Sribusara, P. Streptococcus suis meningitis: An emerging infectious disease of this decade. Buddhachinaraj Med. J. 2017, 34, 211–218. [Google Scholar]
  42. Takeuchi, D.; Kerdsin, A.; Akeda, Y.; Chiranairadul, P.; Loetthong, P.; Tanburawong, N.; Areeratana, P.; Puangmali, P.; Nakayama, T.; Yamamoto, K.; et al. Impact of a Food Safety Campaign on Streptococcus suis Infection in Humans in Thailand. Am. J. Trop. Med. Hyg. 2017, 96, 1370–1377. [Google Scholar] [CrossRef]
  43. Tonesanoi, P. A study of Streptococcus suis infections in hospitalized patients in Sa Kaeo. Chula J. Intern. Med. 2018, 31, 50–65. [Google Scholar]
  44. Rayanakorn, A.; Katip, W.; Lee, L.H.; Oberdorfer, P. Endophthalmitis with bilateral deafness from disseminated Streptococcus suis infection. BMJ Case Rep. 2019, 12, e228501. [Google Scholar] [CrossRef] [PubMed]
  45. Jariyawattanarat, V.; Chantharit, P.; Sritara, C.; Chansoon, T.; Sriphrapradang, C. A case of acute suppurative thyroiditis caused by Streptococcus suis infection. Germs 2021, 11, 592–596. [Google Scholar] [CrossRef] [PubMed]
  46. Mankong, C. Permanent Deafness Due to Streptococcus suis Infection in Kamphaengphet Hospital. Kampheangphet Hosp. J. n.d. Available online: https://www.kph.go.th/html/attachments/article/1128/%E0%B8%A7%E0%B8%B2%E0%B8%A3%E0%B8%AA%E0%B8%B2%E0%B8%A3%201.9.pdf (accessed on 16 October 2022).
  47. Pawan, V.; Areechokchai, D.; Tonghong, A.; Lortheeranuwat, A.; Yapa, R. Outbreak verification summary, 15th Week, 6–12 April 2008. Wkly. Epidemiol. Surveill. Rep. 2008, 39, 263. (In Thaiand) [Google Scholar]
  48. Rungphueng, A.; Harnchaoworakul, W.; Vagus, A.; Sakulngam, J.; Sarueaphirat, N.; Phurahong, S. Outbreak verification summary, 16th Week, 13–19 April 2008. Wkly. Epidemiol. Surveill. Rep. 2008, 39, 279. (In Thailand) [Google Scholar]
  49. Prasarnthong, R.; Tonghong, A.; Leela, T. Outbreak verification summary, 29th Week, 13–19 July 2008. Wkly. Epidemiol. Surveill. Rep. 2008, 39, 514–516. (In Thailand) [Google Scholar]
  50. Diregpoke, B. Outbreak verification summary, 33rd Week, 10–16 August 2008. Wkly. Epidemiol. Surveill. Rep. 2008, 39, 588. (In Thailand) [Google Scholar]
  51. Jirapongsa, C.; Kabphirom, T.; Thepsittha, K.; Phanwadee, M.; Henprasertthae, N.; Tonghong, A. Outbreak verification summary, 32nd Week, 8–14 August 2010. Wkly. Epidemiol. Surveill. Rep. 2010, 41, 513–514. (In Thailand) [Google Scholar]
  52. Vorapani, P.; Sungkot, A.; Kungvan, C.; Nongphan, A.; Phopiam, M. Cluster of Streptococcus suis death, Kongkrailas district, Sukhothai province, December 2009. Wkly. Epidemiol. Surveill. Rep. 2010, 41, 653–656. (In Thailand) [Google Scholar]
  53. Kabphirom, T.; Naruephonjirakul, U.; Yodkhao, A.; Chanthasiriyakorn, S. Outbreak verification summary, 1st Week, 2–8 January 2011. Wkly. Epidemiol. Surveill. Rep. 2011, 42, 6. (In Thailand) [Google Scholar]
  54. Lorpiyanond, T.; Duangngern, P.; Siriarayaporn, P.; Chanthasiriyakorn, S.; Diregpoke, B.; Suwannachairop, O. Outbreak verification summary, 17th Week, 24–30 April 2011. Wkly. Epidemiol. Surveill. Rep. 2011, 42, 265–266. (In Thailand) [Google Scholar]
  55. Thanond, J.; Suwannachairop, O.; Diregpoke, B.; Siriarayaporn, P. Outbreak verification summary, 20th Week, 15–21 May 2011. Wkly. Epidemiol. Surveill. Rep. 2011, 42, 313–314. (In Thailand) [Google Scholar]
  56. Chanthasiriyakorn, S.; Wangtheeraprasert, T.; Yingyong, T. Outbreak verification summary, 25th Week, 19–25 June 2011. Wkly. Epidemiol. Surveill. Rep. 2011, 42, 392–393. (In Thailand) [Google Scholar]
  57. Chainuwatiwong, S.; Monphangtheam, K.; Rattanarat, P.; Thammawichaya, P. Outbreak verification summary, 5th Week, 29 January–4 February 2012. Wkly. Epidemiol. Surveill. Rep. 2012, 43, 70–71. (In Thailand) [Google Scholar]
  58. Prangkratoak, S.; Srisomboon, N.; Tamard, A.; Insean, W.; Siriarayaporn, P. Outbreak verification summary, 10th Week, 3–9 March 2013. Wkly. Epidemiol. Surveill. Rep. 2013, 44, 153–155. (In Thailand) [Google Scholar]
  59. Rungseewong, S.; Worasalsiri, P.; Onsongchan, S.; Kanchanaphibunwong, A. Outbreak verification summary, 39th Week, 22–28 September 2013. Wkly. Epidemiol. Surveill. Rep. 2013, 44, 616–618. (In Thailand) [Google Scholar]
  60. Kanchanasonbut, H.; Yimjohoa, N.; Thanond, J.; Sirirungrueng, A.; Siriarayaporn, P. Outbreak verification summary, 17th Week, 27 April–3 May 2014. Wkly. Epidemiol. Surveill. Rep. 2014, 45, 260–263. (In Thailand) [Google Scholar]
  61. Kulawong, S.; Sathawornwiwat, A.; Toanan, W.; Buathong, R. Outbreak verification summary, 34th Week, 24–30 August 2014. Wkly. Epidemiol. Surveill. Rep. 2014, 45, 534–535. (In Thailand) [Google Scholar]
  62. Sutthachana, S.; Sangchanthip, A.; Samitsuwan, P.; Chanthasiriyakorn, S.; Sukkasame, K.; Phetsindechakul, N.; Siriwatthanasopha, N.; Khampha, V.; Pramuancharuenkit, J.; Panchangamphatthana, A.; et al. Outbreak verification summary, 18th Week, 1–7 May 2016. Wkly. Epidemiol. Surveill. Rep. 2016, 47, 277–279. (In Thailand) [Google Scholar]
  63. Krobtrakulchai, S.; Tunchiangsai, K.; Suthachana, S.; Thepsittha, K.; Kumphol, P.; Sukkham, S.; Sukkhavej, S.; Lengie, W.; Phunkul, S.; Nakaraj, B.; et al. Outbreak verification summary, 34th Week, 21–27 August 2016. Wkly. Epidemiol. Surveill. Rep. 2016, 47, 536–538. (In Thailand) [Google Scholar]
  64. Chanpen, O.; Surinsak, W.; Sittiprapa, W.; Jullanan, W. Investigation of Streptococcus suis death, Salalumduan subdistrict, Mueang district, Sakaeo province, Thailand, May 2016. Wkly. Epidemiol. Surveill. Rep. 2017, 48, 401–406. (In Thailand) [Google Scholar]
  65. Wijitraphan, T.; Inmoon, A. An outbreak investigation of Streptococcus suis infection, Maewang District, Chiang Mai Province, Thailand, June 2017. Wkly. Epidemiol. Surveill. Rep. 2017, 48, 529–536. (In Thailand) [Google Scholar]
  66. Srisupap, W.; Narueponjirakul, U.; Suttawong, T.; Swaddiwudhipong, W. A case Investigation of Streptococcus suis infection in a patient with total knee arthroplasty, Thepharak District, Nakhon Ratchasima Province, Thailand, August 2018. Wkly. Epidemiol. Surveill. Rep. 2019, 50, 17–23. (In Thailand) [Google Scholar]
  67. Somboon, T.; Promduangsi, P.; Arpakhappakul, J.; Kekarakrungreung, N.; Sukpan, S.; Khamjai, N. An outbreak investigation of Streptococcus suis infection, Lamphun province, Thailand, August 2020. Wkly. Epidemiol. Surveill. Rep. 2021, 52, 389–398. (In Thailand) [Google Scholar]
  68. Simkum, S. Investigation of Streptococcus suis outbreak in Mueang, Phetchabul Province, in 2010. In Report of Outbreak Investigation; Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health: Nonthaburi, Thailand, 2010. (In Thailand) [Google Scholar]
  69. Kerdsin, A.; Oishi, K.; Sripakdee, S.; Boonkerd, N.; Polwichai, P.; Nakamura, S.; Uchida, R.; Sawanpanyalert, P.; Dejsirilert, S. Clonal dissemination of human isolates of Streptococcus suis serotype 14 in Thailand. J. Med. Microbiol. 2009, 58, 1508–1513. [Google Scholar] [CrossRef]
  70. Kerdsin, A.; Hatrongjit, R.; Wongsurawat, T.; Jenjaroenpun, P.; Chopjitt, P.; Boueroy, P.; Fittipaldi, N.; Zheng, H.; Gottschalk, M. Genomic Characterization of Streptococcus suis Serotype 24 Clonal Complex 221/234 From Human Patients. Front. Microbiol. 2021, 12, 812436. [Google Scholar] [CrossRef] [PubMed]
  71. Kerdsin, A.; Takeuchi, D.; Akeda, Y.; Nakamura, S.; Gottschalk, M.; Oishi, K. Genomic differences between sequence types 1 and 104 of Streptococcus suis Serotype 2. PeerJ 2022, 10, e14144. [Google Scholar] [CrossRef]
  72. Takeuchi, D.; Akeda, Y.; Nakayama, T.; Kerdsin, A.; Sano, Y.; Kanda, T.; Hamada, S.; Dejsirilert, S.; Oishi, K. The Contribution of Suilysin to the Pathogenesis of Streptococcus suis Meningitis. J. Infect. Dis. 2014, 209, 1509–1519. [Google Scholar] [CrossRef] [Green Version]
  73. Kerdsin, A.; Takeuchi, D.; Nuangmek, A.; Akeda, Y.; Gottschalk, M.; Oishi, K. Genotypic Comparison between Streptococcus suis Isolated from Pigs and Humans in Thailand. Pathogens 2020, 9, 50. [Google Scholar] [CrossRef]
  74. Maneerat, K.; Yongkiettrakul, S.; Kramomtong, I.; Tongtawe, P.; Tapchaisri, P.; Luangsuk, P.; Chaicumpa, W.; Gottschalk, M.; Srimanote, P. Virulence Genes and Genetic Diversity of Streptococcus suis Serotype 2 Isolates from Thailand. Transbound. Emerg. Dis. 2013, 60 (Suppl. 2), 69–79. [Google Scholar] [CrossRef]
  75. Tharavichitkul, P.; Wongsawan, K.; Takenami, N.; Pruksakorn, S.; Fongcom, A.; Gottschalk, M.; Khanthawa, B.; Supajatura, V.; Takai, S. Correlation between PFGE Groups and mrp/epf/sly Genotypes of Human Streptococcus suis Serotype 2 in Northern Thailand. J. Pathog. 2014, 2014, 350416. [Google Scholar] [PubMed]
  76. Bamphensin, N.; Chopjitt, P.; Hatrongjit, R.; Boueroy, P.; Fittipaldi, N.; Gottschalk, M.; Kerdsin, A. Non-Penicillin-Susceptible Streptococcus suis Isolated from Humans. Pathogens 2021, 10, 1178. [Google Scholar] [CrossRef] [PubMed]
  77. Vilaichone, R.K.; Mahachai, V.; Nunthapisud, P. Streptococcus suis peritonitis: Case report. J. Med. Assoc. Thail. 2000, 83, 1274–1277. [Google Scholar]
  78. Bojarska, A.; Molska, E.; Janas, K.; Skoczynska, A.; Stefaniuk, E.; Hryniewicz, W.; Sadowy, E. Streptococcus suis in invasive human infections in Poland: Clonality and determinants of virulence and antimicrobial resistance. Eur. J. Clin. Microbiol. Infect. Dis. 2016, 35, 917–925. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  79. Hoa, N.T.; Chieu, T.T.; Nghia, H.D.; Mai, N.T.; Anh, P.H.; Wolbers, M.; Baker, S.; Campbell, J.I.; Chau, N.V.; Hien, T.T.; et al. The antimicrobial resistance patterns and associated determinants in Streptococcus suis isolated from humans in southern Vietnam, 1997–2008. BMC Infect. Dis. 2011, 11, 6. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  80. Marie, J.; Morvan, H.; Berthelot-Hérault, F.; Sanders, P.; Kempf, I.; Gautier-Bouchardon, A.V.; Jouy, E.; Kobisch, M. Antimicrobial susceptibility of Streptococcus suis isolated from swine in France and from humans in different countries between 1996 and 2000. J. Antimicrob. Chemother. 2002, 50, 201–209. [Google Scholar] [CrossRef] [PubMed]
  81. Ye, C.; Bai, X.; Zhang, J.; Jing, H.; Zheng, H.; Du, H.; Cui, Z.; Zhang, S.; Jin, D.; Xu, Y.; et al. Spread of Streptococcus suis sequence type 7, China. Emerg. Infect. Dis. 2008, 14, 787–791. [Google Scholar] [CrossRef]
  82. Chang, B.; Wada, A.; Ikebe, T.; Ohnishi, M.; Mita, K.; Endo, M.; Matsuo, H.; Asatuma, Y.; Kuramoto, S.; Sekiguchi, H.; et al. Characteristics of Streptococcus suis isolated from patients in Japan. Jpn. J. Infect. Dis. 2006, 59, 397–399. [Google Scholar]
  83. Chu, Y.W.; Cheung, T.K.; Chu, M.Y.; Tsang, V.Y.; Fung, J.T.; Kam, K.M.; Lo, J.Y. Resistance to tetracycline, erythromycin and clindamycin in Streptococcus suis serotype 2 in Hong Kong. Int. J. Antimicrob. Agents 2009, 34, 181–182. [Google Scholar] [CrossRef]
  84. Nga, T.V.T.; Nghia, H.D.T.; Tu, L.T.P.; Diep, T.S.; Mai, N.T.H.; Chau, T.T.H.; Sinh, D.X.; Phu, N.H.; Chau, N.V.V.; Campbell, J.; et al. Real-time PCR for detection of Streptococcus suis serotype 2 in cerebrospinal fluid of human patients with meningitis. Diagn. Microbiol. Infect. Dis. 2011, 70, 461–467. [Google Scholar] [CrossRef] [Green Version]
  85. Nakayama, T.; Zhao, J.; Takeuchi, D.; Kerdsin, A.; Chiranairadul, P.; Areeratana, P.; Loetthong, P.; Pienpringam, A.; Akeda, Y.; Oishi, K. Colloidal gold-based immunochromatographic strip test compromising optimised combinations of anti-S. suis capsular polysaccharide polyclonal antibodies for detection of Streptococcus suis. Biosens. Bioelectron. 2014, 60, 175–179. [Google Scholar] [CrossRef] [PubMed]
  86. Zhang, X.; Wu, Z.; Wang, K. Diagnosis of Streptococcus suis Meningoencephalitis with metagenomic next-generation sequencing of the cerebrospinal fluid: A case report with literature review. BMC Infect. Dis. 2020, 20, 884. [Google Scholar] [CrossRef] [PubMed]
  87. Thu, I.; Tragoolpua, K.; Intorasoot, S.; Anukool, U.; Khamnoi, P.; Kerdsin, A.; Tharinjaroen, C.S. Direct detection of Streptococcus suis from cerebrospinal fluid, positive hemoculture, and simultaneous differentiation of serotypes 1, 1/2, 2, and 14 within single reaction. Pathogens 2021, 10, 996. [Google Scholar] [CrossRef] [PubMed]
  88. Lun, Z.-R.; Wang, Q.-P.; Chen, X.-G.; Li, A.-X.; Zhu, X.-Q. Streptococcus suis: An emerging zoonotic pathogen. Lancet Infect. Dis. 2007, 7, 201–209. [Google Scholar] [CrossRef]
Tropicalmed 07 00359 g001 550
Figure 1. Human S. suis cases in Thailand 2011–2022 reported in R506 system by the Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health. For 2022, data are provided only up to September.
Figure 1. Human S. suis cases in Thailand 2011–2022 reported in R506 system by the Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health. For 2022, data are provided only up to September.
Tropicalmed 07 00359 g001
Table
Table 1. Characteristics of human Streptococcus suis cases in Thailand 1987–2021.
Table 1. Characteristics of human Streptococcus suis cases in Thailand 1987–2021.
CharacteristicNumber of Cases
Total cases1798
Sex (n = 1679)
Male1287 (76.6%)
Female392 (23.4%)
Ratio of male-to-female3.3:1
Age range (years)0.15–92
Occupation (n = 288)
Farmer/gardener153 (53.1%)
Worker/laborer71 (24.6%)
Employee/officer (government or private)45 (15.6%)
Butcher12 (4.2%)
Cook4 (1.4%)
Housewife3 (1.1%)
Risk behavior (n = 1430)
Consumption of raw pork/pig’s blood dishes878 (61.4%)
Exposure to pig/raw pork products139 (9.7%)
Raw pork product consumption and pig/raw pork exposure35 (2.5%)
Alcohol drinking/alcoholism362 (25.3%)
No history of pig/raw pork contact or consumption16 (1.1%)
Outcome (n = 1798)
Alive1438 (80%)
Dead218 (12.1%)
No information142 (7.9%)
Fatality rate12.1%
Clinical presentation/type of infection (n = 1736)
Meningitis709 (40.8%)
Meningitis and septic arthritis12 (0.7%)
Meningitis and spondylodiscitis1 (0.06%)
Spondylodiscitis19 (1.1%)
Septicemia/sepsis748 (43.1%)
Septic shock67 (3.8%)
Infective endocarditis111 (6.4%)
Septic arthritis51 (2.9%)
Peritonitis6 (0.4%)
Pneumonia/pulmonary edema5 (0.3%)
Endophthalmitis4 (0.2%)
Cellulitis1 (0.06%)
Acute suppurative thyroiditis1 (0.06%)
Cholecystitis1 (0.06%)
Complication (n = 432)
Hearing loss or deafness324 (75%)
Acute respiratory distress syndrome (ARDS)23 (5.3%)
Acute renal failure23 (5.3%)
Disseminated intravascular coagulation (DIC)19 (4.4%)
Ataxia12 (2.7%)
Shock11 (2.5%)
Cranial nerve palsy5 (1.2%)
Hemiparesis/paralysis4 (0.9%)
Congestive heart failure3 (0.7%)
Papilledema3 (0.7%)
Intracerebral hemorrhage2 (0.5%)
Subdural empyema1 (0.2%)
Intervertebral discitis1 (0.2%)
Stroke1 (0.2%)
Predisposition (n = 455)
Diabetes mellitus53 (11.6%)
Hypertension53 (11.6%)
Heart disease46 (10.1%)
Spondylitis27 (5.9%)
Systemic lupus erythematosus (SLE)21 (4.6%)
Dyslipidemia16 (3.5%)
Adrenoleukodystrophy (ALD)16 (3.5%)
Liver cirrhosis13 (2.9%)
Gout/rheumatoid4 (0.9%)
Splenectomy2 (0.4%)
Cancer2 (0.4%)
HIV/AIDS2 (0.4%)
Down syndrome1 (0.2%)
Thyroid1 (0.2%)
Anemia1 (0.2%)
Spinal canal stenosis1 (0.2%)
Unspecified or other underlying diseases16 (3.5%)
No predisposing factors/healthy180 (39.6%)
Table
Table 2. Distribution of genotypes of S. suis isolates from humans.
Table 2. Distribution of genotypes of S. suis isolates from humans.
SerotypeClonal ComplexSequence TypeReference
211, 11, 105, 126, 144, 298, 337[18,21,22,23,24,25,29,32,36,37,38,69]
https://pubmlst.org/organisms/streptococcus-suis (accessed on 5 October 2022)
2525, 102, 103, 380, 381, 395, 515, 516
2828, 382
104101, 104, 391, 392, 393, 512, 513, 514
233/379233, 379, 1656, 1713
1687/16881687, 1688
Singleton232, 236
49494
5221/234221
Singleton181, 235
91616
14111, 105, 127
24221/234221, 234
31
(Unencapsulated)		221/234221
Unencapsulated
serotype 2 or 1/2		2828
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Kerdsin, A. Human Streptococcus suis Infections in Thailand: Epidemiology, Clinical Features, Genotypes, and Susceptibility. Trop. Med. Infect. Dis. 2022, 7, 359. https://doi.org/10.3390/tropicalmed7110359

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Kerdsin A. Human Streptococcus suis Infections in Thailand: Epidemiology, Clinical Features, Genotypes, and Susceptibility. Tropical Medicine and Infectious Disease. 2022; 7(11):359. https://doi.org/10.3390/tropicalmed7110359

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Kerdsin, Anusak. 2022. "Human Streptococcus suis Infections in Thailand: Epidemiology, Clinical Features, Genotypes, and Susceptibility" Tropical Medicine and Infectious Disease 7, no. 11: 359. https://doi.org/10.3390/tropicalmed7110359

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