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Group A streptococcal (Streptococcus pyogenes) bacteremia in adults

Author
Dennis L Stevens, MD, PhD
Section Editor
Daniel J Sexton, MD
Deputy Editor
Elinor L Baron, MD, DTMH

INTRODUCTION

Group A Streptococcus (GAS; Streptococcus pyogenes) is an aerobic gram-positive coccus that causes an array of infections, including:

A variety of cutaneous infections (eg, cellulitis, erysipelas, pyoderma)

Necrotizing fasciitis

Myositis or myonecrosis

Pharyngitis

                

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Literature review current through: Nov 2016. | This topic last updated: Mon Apr 04 00:00:00 GMT+00:00 2016.
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References
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  1. Stevens DL. Invasive group A streptococcus infections. Clin Infect Dis 1992; 14:2.
  2. Kiska DL, Thiede B, Caracciolo J, et al. Invasive group A streptococcal infections in North Carolina: epidemiology, clinical features, and genetic and serotype analysis of causative organisms. J Infect Dis 1997; 176:992.
  3. Demers B, Simor AE, Vellend H, et al. Severe invasive group A streptococcal infections in Ontario, Canada: 1987-1991. Clin Infect Dis 1993; 16:792.
  4. Megged O, Yinnon AM, Raveh D, et al. Group A streptococcus bacteraemia: comparison of adults and children in a single medical centre. Clin Microbiol Infect 2006; 12:156.
  5. Gaworzewska E, Colman G. Changes in the pattern of infection caused by Streptococcus pyogenes. Epidemiol Infect 1988; 100:257.
  6. Martin PR, Høiby EA. Streptococcal serogroup A epidemic in Norway 1987-1988. Scand J Infect Dis 1990; 22:421.
  7. Schwartz B, Facklam RR, Breiman RF. Changing epidemiology of group A streptococcal infection in the USA. Lancet 1990; 336:1167.
  8. Holm SE, Norrby A, Bergholm AM, Norgren M. Aspects of pathogenesis of serious group A streptococcal infections in Sweden, 1988-1989. J Infect Dis 1992; 166:31.
  9. Oppegaard O, Mylvaganam H, Kittang BR. Beta-haemolytic group A, C and G streptococcal infections in Western Norway: a 15-year retrospective survey. Clin Microbiol Infect 2015; 21:171.
  10. Smit PW, Lindholm L, Lyytikäinen O, et al. Epidemiology and emm types of invasive group A streptococcal infections in Finland, 2008-2013. Eur J Clin Microbiol Infect Dis 2015; 34:2131.
  11. Ikebe T, Tominaga K, Shima T, et al. Increased prevalence of group A streptococcus isolates in streptococcal toxic shock syndrome cases in Japan from 2010 to 2012. Epidemiol Infect 2015; 143:864.
  12. Plainvert C, Loubinoux J, Bidet P, et al. [Epidemiology of Streptococcus pyogenes invasive diseases in France (2007-2011)]. Arch Pediatr 2014; 21 Suppl 2:S62.
  13. Stevens DL, Tanner MH, Winship J, et al. Severe group A streptococcal infections associated with a toxic shock-like syndrome and scarlet fever toxin A. N Engl J Med 1989; 321:1.
  14. Stevens DL, Salmi DB, McIndoo ER, Bryant AE. Molecular epidemiology of nga and NAD glycohydrolase/ADP-ribosyltransferase activity among Streptococcus pyogenes causing streptococcal toxic shock syndrome. J Infect Dis 2000; 182:1117.
  15. Meehan M, Murchan S, Bergin S, et al. Increased incidence of invasive group A streptococcal disease in Ireland, 2012 to 2013. Euro Surveill 2013; 18:20556.
  16. Centers for Disease Control and Prevention. Active Bacterial Core Surveillance (ABCs). ABCs Report: group A Streptococcus, 2005. www.cdc.gov/abcs/reports-findings/survreports/gas05.html (Accessed on July 14, 2011).
  17. Centers for Disease Control and Prevention. Active Bacterial Core Surveillance (ABCs). ABCs Report: group A Streptococcus, 2006. www.cdc.gov/abcs/reports-findings/survreports/gas06.html (Accessed on July 14, 2011).
  18. Centers for Disease Control and Prevention. Active Bacterial Core Surveillance (ABCs). ABCs Report: group A Streptococcus, 2007. www.cdc.gov/abcs/reports-findings/survreports/gas07.html (Accessed on July 14, 2011).
  19. Centers for Disease Control and Prevention. Active Bacterial Core Surveillance (ABCs). ABCs Report: group A Streptococcus, 2008. www.cdc.gov/abcs/reports-findings/survreports/gas08.html (Accessed on July 14, 2011).
  20. Centers for Disease Control and Prevention. Active Bacterial Core Surveillance (ABCs). ABCs Report: group A Streptococcus, 2009. www.cdc.gov/abcs/reports-findings/survreports/gas09.html (Accessed on July 14, 2011).
  21. Centers for Disease Control and prevention. Active Bacterial Core Surveillance (ABCs). ABCs Report: group A Streptococcus, 2010 www.cdc.gov/abcs/reports-findings/survreports/gas10.html (Accessed on May 15, 2012).
  22. Lepoutre A, Doloy A, Bidet P, et al. Epidemiology of invasive Streptococcus pyogenes infections in France in 2007. J Clin Microbiol 2011; 49:4094.
  23. Deutscher M, Schillie S, Gould C, et al. Investigation of a group A streptococcal outbreak among residents of a long-term acute care hospital. Clin Infect Dis 2011; 52:988.
  24. Centers for Disease Control and Prevention (CDC). Invasive group A streptococcus in a skilled nursing facility--Pennsylvania, 2009-2010. MMWR Morb Mortal Wkly Rep 2011; 60:1445.
  25. Keefer CS, Ingelfinger FJ, Spink WW. Significance of hemolytic streptococcic bacteremia; A study of two hundred and forty-six patients. Arch Intern Med 1937; 60:1084.
  26. Ispahani P, Donald FE, Aveline AJ. Streptococcus pyogenes bacteraemia: an old enemy subdued, but not defeated. J Infect 1988; 16:37.
  27. Henkel JS, Armstrong D, Blevins A, Moody MD. Group A beta-hemolytic Streptococcus bacteremia in a cancer hospital. JAMA 1970; 211:983.
  28. Hable KA, Horstmeier C, Wold AD, Washington JA 2nd. Group A -hemolytic streptococcemia. Bacteriologic and clinical study of 44 cases. Mayo Clin Proc 1973; 48:336.
  29. Trence DL, Khan MY, Gerding DN. Beta-hemolytic streptococcal bacteremia in adults: association with cold weather in Minnesota. Minn Med 1981; 64:675.
  30. Barg NL, Kish MA, Kauffman CA, Supena RB. Group A streptococcal bacteremia in intravenous drug abusers. Am J Med 1985; 78:569.
  31. Francis J, Warren RE. Streptococcus pyogenes bacteraemia in Cambridge--a review of 67 episodes. Q J Med 1988; 68:603.
  32. Barnham M. Invasive streptococcal infections in the era before the acquired immune deficiency syndrome: a 10 years' compilation of patients with streptococcal bacteraemia in North Yorkshire. J Infect 1989; 18:231.
  33. Braunstein H. Characteristics of group A streptococcal bacteremia in patients at the San Bernardino County Medical Center. Rev Infect Dis 1991; 13:8.
  34. Tyrrell GJ, Lovgren M, Kress B, Grimsrud K. Invasive group A streptococcal disease in Alberta, Canada (2000 to 2002). J Clin Microbiol 2005; 43:1678.
  35. Muller MP, Low DE, Green KA, et al. Clinical and epidemiologic features of group a streptococcal pneumonia in Ontario, Canada. Arch Intern Med 2003; 163:467.
  36. Kaul R, McGeer A, Low DE, et al. Population-based surveillance for group A streptococcal necrotizing fasciitis: Clinical features, prognostic indicators, and microbiologic analysis of seventy-seven cases. Ontario Group A Streptococcal Study. Am J Med 1997; 103:18.
  37. Bernaldo de Quirós JC, Moreno S, Cercenado E, et al. Group A streptococcal bacteremia. A 10-year prospective study. Medicine (Baltimore) 1997; 76:238.
  38. Davies HD, McGeer A, Schwartz B, et al. Invasive group A streptococcal infections in Ontario, Canada. Ontario Group A Streptococcal Study Group. N Engl J Med 1996; 335:547.
  39. Ejlertsen T, Prag J, Pettersson E, Holmskov A. A 7-month outbreak of relapsing postpartum group A streptococcal infections linked to a nurse with atopic dermatitis. Scand J Infect Dis 2001; 33:734.
  40. Factor SH, Levine OS, Schwartz B, et al. Invasive group A streptococcal disease: risk factors for adults. Emerg Infect Dis 2003; 9:970.
  41. Tyrrell GJ, Lovgren M, St Jean T, et al. Epidemic of group A Streptococcus M/emm59 causing invasive disease in Canada. Clin Infect Dis 2010; 51:1290.
  42. Nielsen HU, Kolmos HJ, Frimodt-Møller N. Beta-hemolytic streptococcal bacteremia: a review of 241 cases. Scand J Infect Dis 2002; 34:483.
  43. Daneman N, Green KA, Low DE, et al. Surveillance for hospital outbreaks of invasive group a streptococcal infections in Ontario, Canada, 1992 to 2000. Ann Intern Med 2007; 147:234.
  44. Ben-Abraham R, Keller N, Vered R, et al. Invasive group A streptococcal infections in a large tertiary center: epidemiology, characteristics and outcome. Infection 2002; 30:81.
  45. Hollm-Delgado MG, Allard R, Pilon PA. Invasive group A streptococcal infections, clinical manifestations and their predictors, Montreal, 1995-2001. Emerg Infect Dis 2005; 11:77.
  46. Langley G, Hao Y, Pondo T, et al. The Impact of Obesity and Diabetes on the Risk of Disease and Death due to Invasive Group A Streptococcus Infections in Adults. Clin Infect Dis 2016; 62:845.
  47. Kaplan EL, Johnson DR, Kuritsky JN. Rectal colonization by group B beta-hemolytic streptococci in a geriatric population. J Infect Dis 1983; 148:1120.
  48. Beaudoin AL, Torso L, Richards K, et al. Invasive group A Streptococcus infections associated with liposuction surgery at outpatient facilities not subject to state or federal regulation. JAMA Intern Med 2014; 174:1136.
  49. Sierra JM, Sánchez F, Castro P, et al. Group A streptococcal infections in injection drug users in Barcelona, Spain: epidemiologic, clinical, and microbiologic analysis of 3 clusters of cases from 2000 to 2003. Medicine (Baltimore) 2006; 85:139.
  50. Hamilton SM, Bayer CR, Stevens DL, Bryant AE. Effects of selective and nonselective nonsteroidal anti-inflammatory drugs on antibiotic efficacy of experimental group A streptococcal myonecrosis. J Infect Dis 2014; 209:1429.
  51. Hamilton SM, Bayer CR, Stevens DL, et al. Muscle injury, vimentin expression, and nonsteroidal anti-inflammatory drugs predispose to cryptic group A streptococcal necrotizing infection. J Infect Dis 2008; 198:1692.
  52. Bullowa, JGM, Wishik, SM. Complications of varicella I. Their occurrence among 2,534 patients. Am J Dis Child 1935; 49:923.
  53. Hamilton SM, Stevens DL, Bryant AE. Pregnancy-related group a streptococcal infections: temporal relationships between bacterial acquisition, infection onset, clinical findings, and outcome. Clin Infect Dis 2013; 57:870.
  54. Richter SS, Heilmann KP, Beekmann SE, et al. Macrolide-resistant Streptococcus pyogenes in the United States, 2002-2003. Clin Infect Dis 2005; 41:599.
  55. Stevens DL, Gibbons AE, Bergstrom R, Winn V. The Eagle effect revisited: efficacy of clindamycin, erythromycin, and penicillin in the treatment of streptococcal myositis. J Infect Dis 1988; 158:23.
  56. Stevens DL, Bryant AE, Yan S. Invasive group A streptococcal infection: New concepts in antibiotic treatment. Int J Antimicrob Agents 1994; 4:297.
  57. Zimbelman J, Palmer A, Todd J. Improved outcome of clindamycin compared with beta-lactam antibiotic treatment for invasive Streptococcus pyogenes infection. Pediatr Infect Dis J 1999; 18:1096.
  58. Gastanaduy AS, Kaplan EL, Huwe BB, et al. Failure of penicillin to eradicate group A streptococci during an outbreak of pharyngitis. Lancet 1980; 2:498.
  59. Gooskens J, Neeling AJ, Willems RJ, et al. Streptococcal toxic shock syndrome by an iMLS resistant M type 77 Streptococcus pyogenes in the Netherlands. Scand J Infect Dis 2005; 37:85.
  60. Chen I, Kaufisi P, Erdem G. Emergence of erythromycin- and clindamycin-resistant Streptococcus pyogenes emm 90 strains in Hawaii. J Clin Microbiol 2011; 49:439.
  61. Prevention of Invasive Group A Streptococcal Infections Workshop Participants. Prevention of invasive group A streptococcal disease among household contacts of case patients and among postpartum and postsurgical patients: recommendations from the Centers for Disease Control and Prevention. Clin Infect Dis 2002; 35:950.