Streptococcal Invasive Disease Group A, 2012
MDH has been conducting active surveillance for invasive disease caused by group A Streptococcus (GAS), also known as Streptococcus pyogenes since 1995. Invasive GAS is defined as GAS isolated from a usual sterile site such as blood, cerebral spinal fluid, or from a wound when accompanied with necrotizing fasciitis or streptococcal toxic shock syndrome (STSS).
One hundred sixty-nine cases of invasive GAS disease (3.2 cases per 100,000 population), including 18 deaths, were reported in 2012, compared to 231 cases and 17 deaths in 2011. Ages of cases ranged from 0 to 101 years (median, 51 years). Fifty-six percent of cases were residents of the metropolitan area. Forty-five (27%) cases had bacteremia without another focus of infection, 59 (35%) cases had cellulitis, and 13 (8%) cases had an abscess, 18 (11%) cases had septic arthritis and/or osteomyelitis. There were 14 (8%) cases of pneumonia and 11 (7%) cases of necrotizing fasciitis. Twelve (7%) cases were residents of 11 different long-term care facilities.
The 18 deaths included 7 cases of bacteremia without another focus of infection, 4 cases of pneumonia, 2 cases of septic shock, and 1 case with cellulitis. The remaining 4 cases had multiple syndromes including 1 case with necrotizing fasciitis and septic shock; 1 case of necrotizing fasciitis and cellulitis; 1 case of cellulitis and septic shock, and 1 case of pneumonia and septic shock. The deaths occurred in persons ranging in age from less than 1 year to 101 years. Two fatal cases had no underlying medical conditions reported. Of the 15 cases where underlying medical condition was known the most frequently reported were congestive heart failure (6), atherosclerotic cardiovascular disease (6), and diabetes (5).
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