Group A Streptococcus (GAS) soft-tissue infections: A lethal organism on the rise

Several reports over the past decade have suggested that there has been an increase in the number of invasive streptococcal infections with young chil dren and the elderly being at the highest risk. We evaluated the incidence of group A Streptococcus (GAS) and compared it with historic data collected at our institution. Prospective data were collected on patients diagnosed with GAS (with and without shock) admitted to a tertiary-care center from J uly 1995 to July 2000. Each patient was followed by an infectious disease s pecialist throughout the hospital stay. Definitions of streptococcal toxic shock syndrome (STSS) developed by the Centers for Disease Control and Prev ention were used. Thirty-eight patients (mean age of 39 +/- 12) presenting with GAS soft-tissue infections were admitted to our institution over a 5-y ear period (7.6 patients per year). Fourteen (37%) were diagnosed with STSS . This represents a greater than fourfold increase in the average number of cases per year of patients diagnosed with GAS and a nearly 4.5 times great er increase in the annual number of patients diagnosed with STSS. The overa ll mortality of patients diagnosed with GAS was 13 per cent, which increase d to 36 per cent in patients diagnosed with STSS. We conclude that there ha s been a significant increase in the incidence of GAS soft-tissue infection s over the past 5 years at our institution. This may represent a new virule nt strain, as the majority of these infections did not occur in typical hig h-risk patients at the extremes of their lives. Further epidemiologic popul ation-based studies are needed to further delineate the severe nature of th is problem.