Streptococcal Infections
A group of infections caused by bacteria of the Streptococcus family, which are among the most common bacteria in humans. These infections are responsible for a wide range of health problems, including SCARLET FEVER or wound infections. Different groups of Strep bacteria are separated according to letters, from Group A through T. Some types of strep exist harmlessly in the throat; if the bacteria gets in the bloodstream, they are usually destroyed, unless the child has a heart condition, which may lead to bacterial endocarditis. Other types of strep bacteria can lead to sore throats, TONSILLITIS, EAR INFECTIONS, STREP THROAT, or PNEUMONIA. These same bacteria may lead to RHEUMATIC FEVER.
Common throughout the world among schoolaged children, incidence of infection has decreased since the beginning of the 21st century. The dangers of resistance to antibiotics were of little concern with these infections until the 1970s, when penicillin-resistant strains of strep bacteria began to crop up. In addition, various types of strep bacteria continue to mutate, some becoming less virulent and others becoming more so. For example, as strep A infections became less worrisome, strep B infections became more virulent. Then in the 1980s strep A became more dangerous again; a much stronger S. pneumoniae is part of this resurging tide of infection.
Group A Strep
Group A strep (GAS) is responsible for most cases of strep illness. Syndromes caused by group A strep include strep throat, skin infections such as CELLULITIS and IMPETIGO, and PNEUMONIA. Occasionally, group A strep can cause much more severe diseases, such as flesh-eating disease (necrotizing fasciitis) and streptococcal TOXIC SHOCK SYNDROME.
Invasive GAS disease is a severe, sometimes lifethreatening infection, in which the bacteria have spread to other parts of the body, such as the blood, muscle and fat tissue, or the lungs. Two of the most severe (but least common) forms are necrotizing fasciitis (infection of muscle and fat tissue) and toxic shock syndrome. About 20 percent of patients with necrotizing fasciitis and 60 percent of those with streptococcal toxic shock syndrome (STSS) will die; only 10 to 15 percent of those with other forms of invasive group A strep die.
About 10,000 to 15,000 cases of invasive GAS occur in the United States each year, causing more than 2,000 deaths. The Centers for Disease Control estimates between 500 and 1,500 cases of necrotizing fasciitis and 2,000 to 3,000 cases of STSS each year in the United States; on the other hand, there are several million cases of strep throat and impetigo each year.
In 2001 scientists cracked the genetic code of the bacteria, which may lead to better treatments for the illnesses it causes. Now that the bacteria’s complete DNA sequences have been determined, scientists hope they can develop other antibiotics or vaccinations for the organism.
Invasive GAS disease occurs when the bacteria gets past the body’s immune defenses. The germs are spread by direct contact with nose and throat discharge, or by touching infected skin lesions. The risk is greatest when the child is ill or has an infected wound. Health conditions that impair the immune system make infection with GAS more likely. In addition, there are some strains of GAS that are more likely to cause serious disease.
Most children who come in contact with a virulent strain of GAS still will not develop invasive disease; most will have a simple throat or skin infection. Some may not have any symptoms at all. While it is possible for a healthy child to contract invasive GAS, those with chronic conditions such as cancer, diabetes, or kidney problems, or who use steroid medications, are at highest risk.
There have been no reports of casual contacts (such as classmates) developing invasive GAS disease after contact with a patient. However, occasionally close family contacts have developed severe disease. There are no current recommendations regarding whether close family contacts should be tested and treated for disease if a family member becomes ill.
Treatment Group A strep bacteria can be treated with common antibiotics; penicillin is the drug of choice for both mild and severe disease. In addition to antibiotics, supportive care in an intensive care unit and sometimes surgery is needed. Early treatment can reduce the threat of death, although even the best therapy may not prevent death in every case.
Prevention Hand-washing may help stop the spread of all types of group A strep infections, especially after coughing or sneezing and before preparing food. Those with a strep throat should stay home from work or school or day care until 24 hours after taking an antibiotic. Wounds should be cleansed and watched for signs of possible infection.
Early signs and symptoms of necrotizing fasciitis include fever, severe pain and swelling, and redness at wound site. Early signs of STSS include fever, dizziness, confusion, rash, and abdominal pain.
Group B Strep
Group B strep (GBS) causes most of the strep infections in newborns and mothers who have just delivered. Each year there are more than 50,000 cases in pregnant women. It is the most common cause of blood infections (sepsis), MENINGITIS, and pneumonia in newborns. About 15,000 to 18,000 infants are infected in the United States each year, and up to 15 percent of these die. Those who survive may have hearing or vision problems or developmental disabilities. While many people carry group B strep in their bodies, most do not get sick. Other common diseases caused by GBS include blood infections, skin or soft tissue infections, and pneumonia.
Symptoms About 2 percent of infants infected with GBS develop symptoms, most appearing during the first week of life—usually within a few hours after birth. It is also possible for infants to contract GBS several months after birth; meningitis is more common with this type of late-onset disease.
Diagnosis GBS can be diagnosed by growing bacteria in spinal fluid or blood cultures, which can take a few days to complete.
Treatment Antibiotics (penicillin or ampicillin) are the treatment of choice.
Prevention Since one-third of pregnant women carry GBS bacteria, all pregnant women should be screened for the bacteria at 35 to 37 weeks of pregnancy. Most GBS among newborns can be prevented by giving infected pregnant women antibiotics through the vein during labor. Any pregnant woman who has had a baby with GBS disease, or who has GBS infection should receive antibiotics during labor. Women who have been diagnosed with GBS infection at labor are at higher risk if they have fever during labor, rupture of membranes 18 hours or more before delivery, are black, are under age 20, or have labor or rupture of membranes before 37 weeks. Women who have GBS but do not have these risk factors have a relatively low risk of delivering a baby with GBS disease. Unfortunately, some babies still get GBS in spite of testing and antibiotics. Vaccines to prevent GBS disease are being developed, but are still years away.
Common throughout the world among schoolaged children, incidence of infection has decreased since the beginning of the 21st century. The dangers of resistance to antibiotics were of little concern with these infections until the 1970s, when penicillin-resistant strains of strep bacteria began to crop up. In addition, various types of strep bacteria continue to mutate, some becoming less virulent and others becoming more so. For example, as strep A infections became less worrisome, strep B infections became more virulent. Then in the 1980s strep A became more dangerous again; a much stronger S. pneumoniae is part of this resurging tide of infection.
Group A Strep
Group A strep (GAS) is responsible for most cases of strep illness. Syndromes caused by group A strep include strep throat, skin infections such as CELLULITIS and IMPETIGO, and PNEUMONIA. Occasionally, group A strep can cause much more severe diseases, such as flesh-eating disease (necrotizing fasciitis) and streptococcal TOXIC SHOCK SYNDROME.
Invasive GAS disease is a severe, sometimes lifethreatening infection, in which the bacteria have spread to other parts of the body, such as the blood, muscle and fat tissue, or the lungs. Two of the most severe (but least common) forms are necrotizing fasciitis (infection of muscle and fat tissue) and toxic shock syndrome. About 20 percent of patients with necrotizing fasciitis and 60 percent of those with streptococcal toxic shock syndrome (STSS) will die; only 10 to 15 percent of those with other forms of invasive group A strep die.
About 10,000 to 15,000 cases of invasive GAS occur in the United States each year, causing more than 2,000 deaths. The Centers for Disease Control estimates between 500 and 1,500 cases of necrotizing fasciitis and 2,000 to 3,000 cases of STSS each year in the United States; on the other hand, there are several million cases of strep throat and impetigo each year.
In 2001 scientists cracked the genetic code of the bacteria, which may lead to better treatments for the illnesses it causes. Now that the bacteria’s complete DNA sequences have been determined, scientists hope they can develop other antibiotics or vaccinations for the organism.
Invasive GAS disease occurs when the bacteria gets past the body’s immune defenses. The germs are spread by direct contact with nose and throat discharge, or by touching infected skin lesions. The risk is greatest when the child is ill or has an infected wound. Health conditions that impair the immune system make infection with GAS more likely. In addition, there are some strains of GAS that are more likely to cause serious disease.
Most children who come in contact with a virulent strain of GAS still will not develop invasive disease; most will have a simple throat or skin infection. Some may not have any symptoms at all. While it is possible for a healthy child to contract invasive GAS, those with chronic conditions such as cancer, diabetes, or kidney problems, or who use steroid medications, are at highest risk.
There have been no reports of casual contacts (such as classmates) developing invasive GAS disease after contact with a patient. However, occasionally close family contacts have developed severe disease. There are no current recommendations regarding whether close family contacts should be tested and treated for disease if a family member becomes ill.
Treatment Group A strep bacteria can be treated with common antibiotics; penicillin is the drug of choice for both mild and severe disease. In addition to antibiotics, supportive care in an intensive care unit and sometimes surgery is needed. Early treatment can reduce the threat of death, although even the best therapy may not prevent death in every case.
Prevention Hand-washing may help stop the spread of all types of group A strep infections, especially after coughing or sneezing and before preparing food. Those with a strep throat should stay home from work or school or day care until 24 hours after taking an antibiotic. Wounds should be cleansed and watched for signs of possible infection.
Early signs and symptoms of necrotizing fasciitis include fever, severe pain and swelling, and redness at wound site. Early signs of STSS include fever, dizziness, confusion, rash, and abdominal pain.
Group B Strep
Group B strep (GBS) causes most of the strep infections in newborns and mothers who have just delivered. Each year there are more than 50,000 cases in pregnant women. It is the most common cause of blood infections (sepsis), MENINGITIS, and pneumonia in newborns. About 15,000 to 18,000 infants are infected in the United States each year, and up to 15 percent of these die. Those who survive may have hearing or vision problems or developmental disabilities. While many people carry group B strep in their bodies, most do not get sick. Other common diseases caused by GBS include blood infections, skin or soft tissue infections, and pneumonia.
Symptoms About 2 percent of infants infected with GBS develop symptoms, most appearing during the first week of life—usually within a few hours after birth. It is also possible for infants to contract GBS several months after birth; meningitis is more common with this type of late-onset disease.
Diagnosis GBS can be diagnosed by growing bacteria in spinal fluid or blood cultures, which can take a few days to complete.
Treatment Antibiotics (penicillin or ampicillin) are the treatment of choice.
Prevention Since one-third of pregnant women carry GBS bacteria, all pregnant women should be screened for the bacteria at 35 to 37 weeks of pregnancy. Most GBS among newborns can be prevented by giving infected pregnant women antibiotics through the vein during labor. Any pregnant woman who has had a baby with GBS disease, or who has GBS infection should receive antibiotics during labor. Women who have been diagnosed with GBS infection at labor are at higher risk if they have fever during labor, rupture of membranes 18 hours or more before delivery, are black, are under age 20, or have labor or rupture of membranes before 37 weeks. Women who have GBS but do not have these risk factors have a relatively low risk of delivering a baby with GBS disease. Unfortunately, some babies still get GBS in spite of testing and antibiotics. Vaccines to prevent GBS disease are being developed, but are still years away.
Tags: bacteria of the Streptococcus family, EAR INFECTIONS, Group A strep (GAS), Group B strep (GBS), group of infections, Pneumonia, Rheumatic Fever, SCARLET FEVER, strep throat, Streptococcal Infections, wound infections
Posted in Health and Wellness
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