Invasive streptococcal disease: a review for clinicians
Tom Parks1, Lucinda Barrett2, Nicola Jones3
1Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK.
Introduction:
Streptococci are a genus of Gram-positive bacteria which cause diverse human diseases. Many of these species have the potential to cause invasive infection resulting from the presence of bacteria in a normally sterile site.
Sources Of Data:
Original articles, reviews and guidelines.
Areas Of Agreement:
Invasive infection by a streptococcus species usually causes life-threatening illness. When measured in terms of deaths, disability and cost, these infections remain an important threat to health in the UK. Overall they are becoming more frequent among the elderly and those with underlying chronic illness. New observational evidence has become available to support the use of clindamycin and intravenous immunoglobulin in invasive Group A streptococcal disease.
Areas Of Controversy:
Few interventions for the treatment and prevention of these infections have undergone rigorous evaluation in clinical trials. For example, the role of preventative strategies such as screening of pregnant women to prevent neonatal invasive Group B streptococcal disease needs to be clarified.
Future Prospects:
Studies of invasive streptococcal disease are challenging to undertake, not least because individual hospitals treat relatively few confirmed cases. Instead clinicians and scientists must work together to build national and international networks with the aim of developing a more complete evidence base for the treatment and prevention of these devastating infections.
Insights
Invasive streptococcal infections pose a significant health threat, particularly to the elderly. While clindamycin and IVIG show promise for Group A strains, more research is needed for prevention strategies like Group B screening.
Area of Science:
- Microbiology
- Infectious Diseases
- Public Health
Background:
- Streptococci are Gram-positive bacteria causing various human diseases.
- Invasive infections occur when bacteria enter sterile body sites.
- These infections represent a significant global health burden.
Purpose of the Study:
- To review the current understanding of invasive streptococcal diseases.
- To highlight treatment successes and areas needing further investigation.
- To emphasize the need for collaborative research in this field.
Main Methods:
- Review of original articles, scientific reviews, and clinical guidelines.
- Analysis of existing data on streptococcal infections.
- Synthesis of evidence regarding treatment and prevention.
Main Results:
- Invasive streptococcal infections are life-threatening and increasing in frequency among vulnerable populations.
- Clindamycin and intravenous immunoglobulin show potential in treating invasive Group A streptococcal disease.
- The efficacy of preventative measures, such as screening for Group B streptococcal disease in pregnant women, requires further clarification.
Conclusions:
- Rigorous clinical trials for streptococcal infection interventions are limited.
- Collaborative national and international research networks are essential.
- Developing a stronger evidence base is crucial for effective treatment and prevention strategies.
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Three primary contributing factors have been identified.