Streptococcus pyogenes Bacteraemia: A 27-year Study in a London Teaching Hospital

Department of Microbiology, St. Thomas' Hospital, London, UK.
Infectious Diseases (Impact Factor: 1.5). 02/1997; 29(5):473-8. DOI: 10.3109/00365549709011857
Source: PubMed


The clinical and epidemiological features of 120 episodes of Streptococcus pyogenes bacteraemia in St. Thomas' Hospital between 1970 and 1997 were analysed. One-third of episodes were nosocomial. M1 was the most common serotype, and 29% of strains were non-typable. There was a variety of presenting features, but nearly half of the patients had cellulitis, 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 device. The mortality rate was 19%, and was 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 infections have increased, but the mortality rate and the proportion of patients presenting with shock have decreased, and the increase in cases involved many different M-types.

0 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: We report a case of a centenarian who survived group A streptococcal septicaemia without complications. We would be interested to hear if this patient is the oldest survivor of group A streptococcal septicaemia in the U.K.
    Journal of Infection 06/1999; 38(3):193-4. DOI:10.1016/S0163-4453(99)90251-7 · 4.44 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: In 1998, an unexpected increase of group A streptococci (GAS) in blood cultures was observed at our institution. To determine whether they were from unrelated sporadic cases or attributable to a common source, all isolates were analyzed by pulsed-field gel electrophoresis (PFGE) and by automated ribotyping. Two clusters were found. All isolates, except one, of cluster 2 had been isolated from intravenous drug abusers. All patients were hospitalized either in different hospitals or at different times in the same hospitals indicating that the putative common source is to be found in the drug community rather than in a particular hospital.
    Infection 10/2000; 28(5):314-7. DOI:10.1007/s150100070026 · 2.62 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Bacteremia with beta-hemolytic Streptococci groups A, B, C and G has a mortality rate of approximately 20%. In this study we analyzed the association of various patient risk factors with mortality. Records from 241 patients with beta-hemolytic streptococcal bacteremia were reviewed with particular attention to which predisposing factors were predictors of death. A logistic regression model found age, burns, immunosuppressive treatment and iatrogenic procedures prior to the infection to be significant predictors of death, with odds ratios of 1.7 (per decade), 19.7, 3.6 and 6.8, respectively. In bacteremic patients with erysipelas, mortality increased from 8% to 50% when bullae were observed. No HIV-positive patients or IVDUs died as a result of their bacteremic episode. Surprisingly, we found 49% resistance to tetracycline.
    Infectious Diseases 02/2002; 34(7):483-6. DOI:10.1080/00365540110080737 · 1.50 Impact Factor
Show more