INCIDENCE AND SEVERITY OF GROUP-A STREPTOCOCCAL BACTEREMIA IN A MEDICAL-CENTER IN ISRAEL, 1981-1994

To determine recent trends in the incidence and severity, group A stre ptococcal (GAS) bacteremia was studied over the last 14 Sears (1981-19 94). There were 116 events of GAS bacteremia, representing 1.7% of all bacteremic episodes, without an increase in recent years. A total of 108 patients were available for study. Underlying conditions were foun d in 95 patients (88%), including mainly malignant diseases, chronic o bstructive pulmonary disease, congestive heart failure and diabetes me llitus. A source of the bacteremia was noted in 71 patients (66%), wit h skin and soft tissue infection being the major portal of entry. All isolates were susceptible to penicillin. Overall mortality was 21%. Mo rtality had not increased in recent years, but depended significantly on several clinical factors: increased age; admission temperature; sou rce of bacteremia (highest for GAS bacteremia without an identified so urce); and underlying conditions (highest for diabetes mellitus and ch ronic pulmonary disease, absent for patients with no underlying diseas e). This study shows that neither the incidence nor the severity of GA S bacteremia has increased in recent years, Severity is significantly affected by the source of bacteremia and the presence of underlying co nditions.