Group A Streptococcal Bacteremia: Ten Years’ Experience from a Tertiary Care Center in South India
Jeethu Sreekala Jayakumar
Keywords :
Bacteremia, Group A Streptococcus, Streptococcus pyogenes
Citation Information :
Jayakumar JS. Group A Streptococcal Bacteremia: Ten Years’ Experience from a Tertiary Care Center in South India. Indian J Crit Care Med 2022; 26 (9):1019-1021.
Background: Bacteremia is an uncommon complication of group A streptococcal (GAS) infections. The data on GAS bacteremia is scarce from developing nations such as India. Patients and methods: We performed a retrospective analysis of patients diagnosed with GAS bacteremia in a tertiary care hospital in Kerala, India over a 10-year period (2012–2021) by review of the electronic medical records (EMRs). Results: A total of 58 cases of GAS bacteremia were identified in the study period. Skin/soft tissue infection was the most common source of bacteremia. A total of 34.4% of the patients required ICU admission and the in-hospital mortality was 22.4%. All the GAS isolates were sensitive to penicillin, ampicillin, and ceftriaxone. Erythromycin and clindamycin resistance was seen in 39.7% and 24.1% isolates, respectively. Conclusion: This study shows that despite advancement in medical sciences, GAS bacteremia remains as a disease with high morbidity and mortality. A higher rate of clindamycin resistance was observed compared to previous Indian studies.
Burkert T, Watanakunakorn C. Group A streptococcal bacteremia in a community teaching hospital—1980–1989. Clin Infect Dis 1992;14(1):29–37. DOI: 10.1093/clinids/14.1.29.
Moses AE, Mevorach D, Rahav G, Sacks T, Simhon A, Shapiro M. Group A streptococcus bacteremia at the Hadassah Medical Center in Jerusalem. Clin Infect Dis Off Publ Infect Dis Soc Am 1995;20(5): 1393–1395. DOI: 10.1093/clinids/20.5.1393.
Morales MV, Navarro CJS, Lletí MS, Alonso MM, Bellés CP, Aldeguer JL, et al. Group A streptococcal bacteremia: Outcome and prognostic factors. Rev Espanola Quimioter 2006;19(4):367–375. PMID: 17235407.
Mathur P, Bhardwaj N, Gupta G, Punia P, Tak V, John NV, et al. Outbreak of Streptococcus pyogenes emm type 58 in a high dependency unit of a level-1 trauma center of India. Indian J Crit Care Med 2014; 18(2):77–82. DOI: 10.4103/0972-5229.126076.
Erbay A. Hospital acquired invasive group A streptococcus infections. Indian J Crit Care Med 2014;18(2):57–58. DOI: 10.4103/0972-5229. 126072.
Breathnach AS, Eykyn SJ. Streptococcus pyogenes bacteraemia: A 27-year study in a London teaching hospital. Scand J Infect Dis 1997;29(5):473–478. DOI: 10.3109/00365549709011857.
Mathur P, Bhardwaj N, Mathur K, Behera B, Gupta G, Kapil A, et al. Clinical and molecular epidemiology of beta-hemolytic streptococcal infections in India. J Infect Dev Ctries 2014;13;8(3):297–303. DOI: 10.3855/jidc.3216.
Bhardwaj N, Mathur P, Behera B, Mathur K, Kapil A, Misra MC. Antimicrobial resistance in beta-haemolytic streptococci in India: A four-year study. Indian J Med Res 2018;147(1):81–87. DOI: 10.4103/ijmr.IJMR_1517_16.
Lu B, Fang Y, Fan Y, Chen X, Wang J, Zeng J, et al. High prevalence of macrolide-resistance and molecular characterization of Streptococcus pyogenes isolates circulating in China from 2009 to 2016. Front Microbiol 2017;8:1052. DOI: 10.3389/fmicb.2017.01052.
DeMuri GP, Sterkel AK, Kubica PA, Duster MN, Reed KD, Wald ER. Macrolide and clindamycin resistance in group A streptococci isolated from children with pharyngitis. Pediatr Infect Dis J 2017;36(3): 342–344. DOI: 10.1097/INF.0000000000001442.
