Severe Group a Streptococcal Soft-Tissue Infections in Ontario: 1992-1996

Clin Infect Dis. 2002 Feb 15;34(4):454-60. doi: 10.1086/338466. Epub 2002 Jan 7.

Abstract

A prospective, population-based, surveillance study of invasive soft-tissue infections due to group A streptococci was conducted in Ontario, Canada, from 1992 through 1996. Demographic and clinical information was obtained by patient interview and chart review. Isolates were characterized by M protein and T agglutination typing. The incidence of necrotizing fasciitis (NF) increased from 0.08 cases per 100,000 population in 1992 to 0.49 cases per 100,000 population in 1995. The case-fatality rate was 13% (68 of 520 patients died). Hypotension and multiorgan dysfunction complicated 64 cases (12%), and NF complicated 119 cases (23%). Underlying diabetes, alcohol abuse, cancer, and cardiac and pulmonary disease increased the risk of disease. Prior use of nonsteroidal anti-inflammatory agents did not influence disease severity. All 197 patients without NF, underlying illness, and hypotension at presentation survived, as did 95 (99%) of 96 normotensive patients who were <65 years old but who had underlying chronic illness. Previously healthy patients without hypotension or NF may be considered for outpatient treatment.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Male
  • Middle Aged
  • Ontario / epidemiology
  • Prospective Studies
  • Risk Factors
  • Soft Tissue Infections / epidemiology*
  • Soft Tissue Infections / microbiology
  • Soft Tissue Infections / mortality
  • Streptococcal Infections / epidemiology*
  • Streptococcal Infections / microbiology
  • Streptococcal Infections / mortality
  • Streptococcus pyogenes*