STREPTOCOCCUS-PYOGENES BACTEREMIA - A 27-YEAR STUDY IN A LONDON TEACHING HOSPITAL

The clinical and epidemiological features of 120 episodes of Streptoco ccus pyogenes bacteraemia in St. Thomas' Hospital between 1970 and 199 7 were analysed. One-third of episodes mere nosocomial. M1 was the mos t common serotype, and 29% of strains mere non-typable. There was a va riety of presenting features, but nearly half of the patients had cell ulitis, 15% were shocked, and 6% had necrotic infections, There was no focus of infection in 13%. 54% of patients had an underlying disease, and 23% of infections were associated with a medical procedure or dev ice. The mortality rate mas 19%, and mas associated with shock, coma, no focus of infection, and underlying disease. Since 1989, the annual incidence has more than doubled, and M1 strains and necrotic infection s have increased, but the mortality rate and the proportion of patient s presenting with shock have decreased, and the increase in cases invo lved many different M-types.