Streptococcal Invasive Disease Group A, 2016

Invasive Group A streptococcal disease (GAS) is defined as GAS isolated from a normally sterile site such as blood, cerebrospinal fluid, or wound when accompanied with necrotizing fasciitis or streptococcal toxic shock syndrome (STSS). Two hundred seventy-seven cases (4.8 cases per 100,000 population), including 24 deaths, were reported in 2016, compared to 236 cases and 14 deaths in 2015. Ages of cases ranged from <1 to 99 years (median, 59 years). Fifty percent of cases were residents of the metropolitan area. Allowing for multiple presentations per patient, 94 (34%) had cellulitis, 67 (24%) bacteremia without another focus of infection, 61 (22%) septic shock 26 (9%) septic arthritis and/or osteomyelitis, 27 (10%) pneumonia, 23 (8%) abscess, 19 (7%) necrotizing fasciitis, and 8 (3%) had STSS. Twentyseven (10%) cases were residents of long-term care facilities. Eighteen facilities had a single case, three had 2 cases, and one had 3 cases. The 3 cases at the same facility all matched by PFGE. The 24 deaths included 5 that presented with just septic shock; 4 had bacteremia without another focus of infection; 1 pneumonia; 1 meningitis; 1 empyema; 1 otitis media; 4 both septic shock and cellulitis; 3 both septic shock and pneumonia; and 2 with septic shock, necrotizing fasciitis and STSS (missing information for 2). Of the 24 deaths, the most frequently reported underlying conditions were: atherosclerotic cardiovascular disease (7), heart failure (7), chronic kidney disease (5), chronic obstructive pulmonary disease (4), obesity (4) and diabetes (4). Eight case fatalities had two or more co-morbidities, and 3 had none reported.

• For up to date information see>> Group A Streptococcus (GAS)
• Full issue>> Annual Summary of Communicable Diseases Reported to the Minnesota Department of Health, 2016