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Group A Streptococcus invasive infections: a review
1Department of Microbiology and Infectious Diseases, Hôpital Maisonneuve-Rosemont, Université de Montréal, Que.
Canadian Journal of Surgery. Journal Canadien De Chirurgie
|February 1, 1997
Summary
Group A Streptococcus (GAS) invasive infections are rising globally. Researchers defined severe GAS infections like necrotizing fasciitis, myositis, and streptococcal toxic shock syndrome (STSS).
Area of Science:
- Infectious Diseases
- Microbiology
- Immunology
Background:
- Global incidence of invasive group A Streptococcus (GAS) infections is increasing without clear cause.
- A working group defined severe GAS infections in 1993, identifying key feared entities.
- Severe GAS infections include necrotizing fasciitis, myositis, and streptococcal toxic shock syndrome (STSS).
Purpose of the Study:
- To define severe group A Streptococcus (GAS) infections.
- To characterize the toxins and superantigens produced by GAS.
- To understand the immune response and clinical manifestations of invasive GAS infections.
Main Methods:
- Defining criteria for severe GAS infections.
- Characterizing GAS toxins, specifically streptococcal pyrogenic exotoxins (superantigens).
- Reviewing clinical manifestations and outcomes of invasive GAS infections.
Main Results:
- Identification and definition of necrotizing fasciitis, myositis, and STSS.
- Characterization of streptococcal pyrogenic exotoxins as superantigens crucial to GAS pathogenesis.
- High mortality rates associated with invasive GAS infections (20% for necrotizing fasciitis to nearly 100% for myositis).
Conclusions:
- Invasive group A Streptococcus (GAS) infections, including STSS, are a significant and increasing global health threat.
- GAS superantigens play a critical role in the rapid progression and severity of these infections.
- Effective treatment requires a multi-modal approach including antibiotics, surgery, and immunoglobulins for STSS.