Streptococcal Invasive Disease Group A, 2013

As part of EIP, 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, cerebrospinal fluid, or from a wound when accompanied with necrotizing fasciitis or streptococcal toxic shock syndrome (STSS).

Two hundred nine cases of invasive GAS disease (3.9 cases per 100,000 population), including 14 deaths, were reported in 2013, compared to 169 cases and 18 deaths in 2012. Ages of cases ranged from 0 to 98 years (median, 53 years). Fifty-three percent of cases were residents of the metropolitan area. Eighty-three (40%) cases had cellulitis, 43 (21%) had bacteremia without another focus of infection 30 (14%) had septic arthritis and/or osteomyelitis, 25 (12%) cases had an abscess, 23 (11%) cases had septic shock, and 22 (11%) had necrotizing fasciitis. Twelve (6%) cases were residents of long-term care facilities. Eight facilities had only 1 case, 2 facilities had 2 GAS cases each.

The 14 deaths included 4 cases of bacteremia without another focus of infection, 3 cases septic shock, 2 cases of necrotizing fasciitis, 2 cases of cellulitis, and 1 case each of pneumonia and pleural effusion/pulmonary edema. One case had multiple syndromes including necrotizing fasciitis and septic shock. The deaths occurred in persons ranging in age from 37 to 88 years. One fatal case had no underlying medical conditions reported. Of the 13 cases where underlying medical condition was known the most frequently reported were diabetes (11), atherosclerotic cardiovascular disease (4), chronic renal insufficiency (3), COPD (3), and solid organ malignancy (3).

• For up to date information see>> Group A Streptococcus (GAS)
• Full issue>> Annual Summary of Communicable Diseases Reported to the Minnesota Department of Health, 2013