GROUP-A STREPTOCOCCAL BACTEREMIA - EXPERIENCE AT A UNIVERSITY HOSPITAL IN RIYADH

A recent increase in the frequency and severity of group A beta-haemol ytic streptococcal (GABHS) infections has been reported from several p arts of the world. A retrospective analysis of bacteraemic GABHS infec tions encountered at a major teaching hospital in Riyadh, Saudi Arabia between 1982 and 1993 wets performed The epidemiologic, clinical and laboratory aspects of 29 episodes of GABHS bacteraemia were reviewed a nd the differences between frequency and severity of these episodes we re compared between the initial (1982-1989) and the late (1990-1993) p eriods of the study. The overall frequency of GABHS bacteraemia was 0. 14 episodes per 1000 admissions with no difference between the initial and the late periods. Seventeen patients were adults and 12 were paed iatrics. Adults were mostly females (82%) and paediatrics were predomi nantly males (75%). Seven episodes (24%) were nosocomial. Most patient s (72%) had a predisposing factor for GABHS infections. Primary bacter aemia occurred in 13 patients (45%); and the skin and throat were the major sources of the bacteraemia in the rest of the patients. Shock co mplicated five episodes (17%) and acute renal failure developed in six (21%) patients. The overall case fatality rate was 21%. All five epis odes complicated by shock were in the late period and the rate of acut e renal failure as well as the case fatality rate have doubled in the late vs. the early periods. Although no recent increase in frequency o f GABHS bacteraemia was found invasive GABH infections may have become more severe.