Invasive Group A Streptococcal Disease: Management and Chemoprophylaxis

Allen, UD; Moore, DL

doi:10.1155/2010/585187

Cited by 15 publications

(15 citation statements)

References 12 publications

(13 reference statements)

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“…However, this may still be low given the potential benefits of antitoxin treatment with clindamycin for severe invasive GAS infections previously reported in one study 25 33 34…”

Section: Discussionmentioning

confidence: 99%

When should clinicians suspect group Astreptococcusempyema in children? A multicentre case–control study in French tertiary care centres

et al. 2016

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BackgroundThe incidence of invasive group A streptococcus (GAS) infections is increasing worldwide, whereas there has been a dramatic decrease in pneumococcal invasive diseases. Few data describing GAS pleural empyema in children are available.ObjectiveTo describe the clinical and microbiological features, management and outcome of GAS pleural empyema in children and compare them with those of pneumococcal empyema.Design, setting and patientsFifty children admitted for GAS pleural empyema between January 2006 and May 2013 to 8 hospitals participating in a national pneumonia survey were included in a descriptive study and matched by age and centre with 50 children with pneumococcal empyema.ResultsThe median age of the children with GAS pleural empyema was 2 (range 0.1–7.6) years. Eighteen children (36%) had at least one risk factor for invasive GAS infection (corticosteroid use and/or current varicella). On admission, 37 patients (74%) had signs of circulatory failure, and 31 (62%) had a rash. GAS was isolated from 49/50 pleural fluid samples and from one blood culture. The commonest GAS genotype was emm1 (n=17/22). Two children died (4%). Children with GAS empyema presented more frequently with a rash (p<0.01), signs of circulatory failure (p=0.01) and respiratory disorders (p=0.02) and with low leucocyte levels (p=0.04) than children with pneumococcal empyema. Intensive care unit admissions (p<0.01), drainage procedures (p=0.04) and short-term complications (p=0.01) were also more frequent in patients with GAS empyema.ConclusionsPleural empyema following varicella or presenting with rash, signs of circulatory failure and leucopenia may be due to GAS. These features should prompt the addition to treatment of an antitoxin drug, such as clindamycin.

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“…However, this may still be low given the potential benefits of antitoxin treatment with clindamycin for severe invasive GAS infections previously reported in one study 25 33 34…”

Section: Discussionmentioning

confidence: 99%

When should clinicians suspect group Astreptococcusempyema in children? A multicentre case–control study in French tertiary care centres

et al. 2016

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Section: Discussion and Review Of The Literaturementioning

confidence: 99%

“…An exception is Canada, where invasive group A streptococcal infection is reportable in all provinces and territories . In 2006, guidelines were introduced, which recommended that chemoprophylaxis should be offered to all close contacts of a confirmed case of severe group A streptococcus . In particular, the guidelines recommend the administration of a first‐generation cephalosporin to household contacts, arguing that penicillin is less effective in eradicating GAS colonisation than the cephalosporins .…”

Section: Discussion and Review Of The Literaturementioning

confidence: 99%

“…In 2006, guidelines were introduced, which recommended that chemoprophylaxis should be offered to all close contacts of a confirmed case of severe group A streptococcus . In particular, the guidelines recommend the administration of a first‐generation cephalosporin to household contacts, arguing that penicillin is less effective in eradicating GAS colonisation than the cephalosporins . The guidelines also advise that macrolides such as erythromycin, clarithromycin and azithromycin may be used in individuals with beta‐lactam allergy, but caution about the risk of macrolide‐resistant GAS, which has been documented in 5% of GAS isolates in UK data .…”

Section: Discussion and Review Of The Literaturementioning

confidence: 99%

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Invasive group A streptococcal infection in the Northern Territory, Australia: Case report and review of the literature

Middleton

Morris

Carapetis

2014

J Paediatrics Child Health

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The increasing incidence of invasive group A streptococcus has been well documented in the temperate climates of North America, Europe and the United Kingdom. Studies also suggest that there are high rates of invasive group A streptococcus infection within the indigenous population of Northern Australia. This review article presents the case of infant Aboriginal twins with invasive group A streptococcal infection complicated by streptococcal toxic shock syndrome, highlighting both the severity and high transmissibility of invasive group A streptococcal disease. We review the epidemiology of group A streptococcal infection and suggest a potential role for chemoprophylaxis of household contacts to reduce the burden of disease within the indigenous population of Northern Australia.

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“…1 Canadian guidelines suggest chemoprophylaxis be offered to all close contacts of a confirmed case of iGAS, including those exposed from 7 days pre-onset of symptoms in the case to 24 h after the initiation of antimicrobial therapy. 2 Current UK guidelines also suggest if there are two or more cases of iGAS within a 30-day period, that household contacts should be issued chemoprophylaxis. 3 Current Queensland Communicable Disease Control Guidance records iGAS as a notifiable condition; however, chemoprophylaxis is not routinely recommended.…”

mentioning

confidence: 99%