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Invasive group A streptococcal infections.

P Ferrieri¹, E L Kaplan

¹Department of Laboratory Medicine, University of Minnesota School of Medicine, Minneapolis.

Infectious Disease Clinics of North America

|March 1, 1992

Summary

Severe group A streptococcal infections have increased since the 1980s, likely due to virulent strains. Understanding the epidemiology and pathogenesis of these infections is crucial for effective treatment and prevention.

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Area of Science:

Microbiology
Epidemiology
Infectious Diseases

Background:

Group A Streptococcus (GAS) infections have shown a concerning rise in severity since the mid-1980s.
This increase encompasses both suppurative (pus-forming) and nonsuppurative (non-pus-forming) complications.
The precise reasons for this epidemiological shift are not fully understood.

Observation:

Epidemiological data suggest a resurgence of novel and particularly virulent serotypes of GAS.
These virulent strains appear to be responsible for the heightened severity of infections observed.
The pathogenetic mechanisms driving this increased virulence are still under investigation.

Findings:

While some studies link streptococcal pyrogenic exotoxins (SpeA or SpeB) to severe systemic GAS infections, findings are conflicting.
Clinical presentation is often a rapidly progressing, highly virulent syndrome.
Despite effective in vitro antimicrobial activity, mortality can be high, occurring within hours or days.

Implications:

Current treatment relies on appropriate antibiotic therapy and supportive care for systemic manifestations.
Prevention is challenging as initial GAS infections or colonization are frequently unrecognized.
Further research into the epidemiology, pathogenesis, treatment, and prevention of severe GAS infections is urgently needed.

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