Epidemiological and Clinical Aspects of Invasive Group A Streptococcal Infections and the Streptococcal Toxic Shock Syndrome

Eriksson, B.; Andersson, Jan; Holm, Stig E.; Norgren, Mari

doi:10.1086/515012

Cited by 111 publications

(94 citation statements)

References 12 publications

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“…data), and high rates of GAS skin disease have been found in Pacifi c Islanders in other parts of the world, including in Maoris and other Polynesians in New Zealand (21,22). In most industrialized countries, the annual incidence of invasive GAS disease is 2.5-3.5/100,000 population (8,23), and the case-fatality rate is 7%-15% (6,8,(23)(24)(25)(26). Although some epidemiologic similarities were found between invasive GAS disease in these countries and in Fiji, such as the high rates for elderly persons with coexisting medical conditions, as well as in the clinical spectrum of disease, major differences stand out.…”

Section: Discussionmentioning

confidence: 99%

Prospective Surveillance of Invasive Group A Streptococcal Disease, Fiji, 2005–2007

Steer¹,

Jenney²,

Kado³

et al. 2009

Emerg. Infect. Dis.

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Section: Discussionmentioning

confidence: 99%

Prospective Surveillance of Invasive Group A Streptococcal Disease, Fiji, 2005–2007

Steer¹,

Jenney²,

Kado³

et al. 2009

Emerg. Infect. Dis.

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“…11 These data, although not conclusive of increased incidence, are compatible with results of population-based surveillance in Scandinavia and Israel and several North American hospitalbased case series, which reported an increase in invasive GAS disease in both adults and children in the early 1990s. 6,9,10,12,16,21 Whether this increase represents a shift in the incidence of these infections that will be maintained or a peak in naturally variable incidence remains to be established.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9] Numerous hospital-based case series have been reported on the clinical spectrum of pediatric invasive GAS disease and have identified that varicella-zoster virus (VZV) infection commonly precedes these infections, especially in cases of NF. 10 -21 However, to adequately define the epidemiology of these infections, population-based studies are required.…”

mentioning

confidence: 99%

Invasive Group A Streptococcal Disease in Children and Association With Varicella-Zoster Virus Infection

Davies²,

et al. 2000

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ABSTRACT. Objectives. To describe the incidence and clinical features of invasive group A streptococcal (GAS) disease in children in Ontario and determine the risk of invasive GAS infection following chickenpox.Methods. During 1992-1996, we conducted prospective, active, population-based surveillance for pediatric invasive GAS disease in Ontario, Canada (population: 11 million; 2.5 million children) and reviewed clinical and laboratory records.Results. There were 1.9 cases of invasive GAS disease per 100 000 children per year. Streptococcal toxic shock syndrome (STSS) occurred in 7% of cases and necrotizing fasciitis (NF) in 4% for incidences of .08 and .13 per 100 000 per year, respectively. Case-fatality rates were 56% for STSS, 10% for NF, and 4% overall. The presence of chronic underlying illness other than asthma was associated with death (relative risk [RR]: 11; 95% confidence interval [CI]: 2.4 -45). Fifteen percent of children identified had preceding chickenpox infection, which significantly increased the risk for acquisition of invasive GAS disease (RR: 58; 95% CI: 40 -85). Children with invasive GAS and recent chickenpox were more likely to have NF (RR: 6.3; 95% CI: 1.8 -22.3).Conclusions. Childhood invasive GAS disease occurs at an incidence similar to the adult population but has a lower rate of STSS and case-fatality. Chickenpox dramatically increases the risk for acquiring invasive GAS disease, and universal chickenpox vaccination could potentially prevent up to 15% of all pediatric invasive GAS disease. Pediatrics 2000;105(5). URL: http://www. pediatrics.org/cgi/content/full/105/5/e60; varicella, group A streptococcus, pediatric, risk. ABBREVIATIONS. GAS, group A streptococcus/streptococcal; NF, necrotizing fasciitis; STSS, streptococcal toxic shock syndrome; VZV, varicella-zoster virus; RR, relative risk; CI, confidence interval; IL, interleukin. T he past 15 years have witnessed a striking resurgence in the incidence and severity of infections caused by group A streptococci (GAS), including necrotizing fasciitis (NF) and the streptococcal toxic shock syndrome (STSS).1-9 Numerous hospital-based case series have been reported on the clinical spectrum of pediatric invasive GAS disease and have identified that varicella-zoster virus (VZV) infection commonly precedes these infections, especially in cases of NF.10 -21 However, to adequately define the epidemiology of these infections, population-based studies are required. Published reports from population-based surveillance of invasive GAS infection have included relatively few pediatric cases.3,5 This limits conclusions regarding the incidence and clinical features of this disease in children.Our group previously reported the results of prospective, population-based surveillance for invasive GAS disease in Ontario, Canada, in 1992-1993, identifying 323 cases of which only 81 were in children. 3 The objective of this study was to describe the incidence and clinical features of invasive GAS disease in children in a large population (Ontario) and to b...

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“…Mortality associated with STSS ranged from 33 -81% in four population -based studies. [33][34][35][36] Severe GAS infections may present in any age group, including the neonate, 37 although the incidence is highest in the elderly and the very young. [33][34][35][36] Elderly nursing home residents are at greater risk of severe GAS disease compared with elderly people living in the community.…”

Section: History Of Gas Infectionmentioning

confidence: 99%

“…[33][34][35][36] Severe GAS infections may present in any age group, including the neonate, 37 although the incidence is highest in the elderly and the very young. [33][34][35][36] Elderly nursing home residents are at greater risk of severe GAS disease compared with elderly people living in the community. 36 Healthy, young, immunocompetent children and adults are frequently infected although a higher incidence has been reported in patients with HIV, cancer, diabetes, ethanol abuse or other chronic diseases [33][34][35][36] (Table II).…”

Section: History Of Gas Infectionmentioning

confidence: 99%

Severe group a streptococcal infection and streptococcal toxic shock syndrome

Baxter

McChesney

2000

Can J Anesth/J Can Anesth

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Purpose: To review the literature on group A streptococcal toxic shock syndrome, (STSS). Data source: Medline and EMBASE searches were conducted using the key words group A streptococcal toxic shock syndrome, alone and in combination with anesthesia; and septic shock, combined with anesthesia. Medline was also searched using key words intravenous immunoglobulin, (IVIG) and group A streptococcus, (GAS); and group A streptococcus and antibiotic therapy. Other references were included in this review if they addressed the history, microbiology, pathophysiology, incidence, mortality, presentation and management of invasive GAS infections. Relevant references from the papers reviewed were also considered. Articles on the foregoing topics were included regardless of study design. Non-English language studies were excluded. Literature on the efficacy of IVIG and optimal antibiotic therapy was specifically searched. Principal findings: Reports of invasive GAS infections have recently increased. Invasive GAS infection is associated with a toxic shock syndrome, (STSS), in 8 -14% of cases. The STSS characteristically results in shock and multi-organ failure soon after the onset of symptoms, and is associated with a mortality of 33 -81%. Many of these patients will require extensive soft tissue debridement or amputation in the operating room, on an emergency basis. The extent of tissue debridement required is often underestimated before skin incision. Conclusions: Management of STSS requires volume resuscitation, vasopressor/inotrope infusion, antibiotic therapy and supportive care in an intensive care unit, usually including mechanical ventilation. Intravenous immunoglobulin infusion has been recommended. Further studies are needed to define the role of IVIG in STSS management and to determine optimal anesthetic management of patients with septic shock.Objectif: Passer en revue la documentation sur le syndrome de choc toxique streptococcique de groupe A (SCTS). Sources: Des recherches ont été menées dans Medline et EMBASE en utilisant les mots-clés: group A streptococcal toxic shock syndrome, seul et en combinaison avec anesthesia; septic shock, combiné avec anesthesia. Dans Medline, nous avons aussi utilisé les entrées intravenous immunoglobulin (immunoblobuline intraveineuse, IGIV) et group A streptococcus (streptocoque du groupe A, SGA) et antibiotic therapy. Nous avons retenu d'autres références qui concernaient l'histoire, la microbiologie, la physiopathologie, l'incidence, la mortalité, la présenta-tion et le traitement des infections invasives de SGA. Les références pertinentes provenant des articles révisés ont aussi été conservées. Les articles concernant les sujets déjà cités ont été retenus sans tenir compte du type d'é-tude. On a exclu les études d'autres langues que l'anglais. La documentation sur l'efficacité de l'IGIV et sur l'antibiothérapie optimale a été spécialement recherchée. Constatations principales : Les articles sur les infections envahissantes de SGA ont récemment augmenté. L'infection invasive de ...

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Epidemiological and Clinical Aspects of Invasive Group A Streptococcal Infections and the Streptococcal Toxic Shock Syndrome

Cited by 111 publications

References 12 publications

Prospective Surveillance of Invasive Group A Streptococcal Disease, Fiji, 2005–2007

Prospective Surveillance of Invasive Group A Streptococcal Disease, Fiji, 2005–2007

Invasive Group A Streptococcal Disease in Children and Association With Varicella-Zoster Virus Infection

Severe group a streptococcal infection and streptococcal toxic shock syndrome

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