Invasive group A streptococcal soft tissue infection and the streptococcal toxic shock like syndrome

Abstract

G roup A strep to coc cus is found around the world; its ecologi cal niche is the skin and mu cous mem branes of humans (1). There are more than 80 types of this or gan ism based on a cell wall con stitu ent known as the M-protein, which is also one of its key viru lence fac tors. Group A strepto coc cus can cause a va ri ety of ill nesses rang ing from mild con di tions such as pha ryn gi tis to less com mon, but more de struc tive in fec tions, such as ne cro tiz ing cel lu li tis (2). In the 1800s, there was a world wide pan demic of strep tococ cal in fec tions. From 1885 to the early 1980s, a gen eral decrease in the number of in fec tions oc curred, even be fore the ad vent of an ti bi ot ics. This de cline was thought to be due to cleaner and less crowded liv ing con di tions (3). Be gin ning in 1985, an in creas ing number of out breaks of acute rheu matic