Understanding and Preventing Invasive Streptococcus Pyogenes Infections – 10 Key Facts and Considerations

2023-11-10 12:33:06

The rapid evolution of the contagion curve with the bacteria Streptococcus pyogenes that led to invasive disease so far in 2023 generates concern in the Ministry of Health, which is trying to determine the causes. Until now there has been 487 cases and 78 deaths.

The increase in the incidence of the pathogen is occurring not only in Argentina, but globally. The New York State Department of Health developed a basic guide with ten questions key to understanding what this bacteria is regarding, what the invasive disease is and who it affects.

1- What is Streptococcus pyogenes?

Streptococcus pyogenes, also called group A, is a bacteria that is usually present in the throat and on the skin. Most infections cause relatively mild illnesses, such as strep throat and impetigo. However, sometimes these bacteria can cause much more serious and life-threatening illnesses, such as necrotizing fasciitis (often called “flesh-eating bacteria”) and streptococcal toxic shock syndrome. Additionally, people can carry group A strep in their throat or on their skin without showing any symptoms of the disease.

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This is indicated by new official figures now released by the Ministry of Health.

2- How are group A streptococci spread?

These bacteria are spread by direct contact with nasal or throat secretions from infected people with infected skin lesions. The risk of contagion is greater when the person is sick, for example, when people have strep throat or an infected wound. Asymptomatic carriers of the bacteria are much less contagious. Treating an infected person with an appropriate antibiotic for 24 hours or more eliminates the possibility of infection with the bacteria. However, it is important to carry out the complete antibiotic treatment as it has been formulated. Household items such as plates, cups, toys, etc., are not of major importance in the transmission of the disease.

3- What is a group A invasive disease?

Invasive disease is a serious and sometimes fatal infection in which bacteria invade different parts of the body, such as the blood, deep muscles and fatty tissue, or lungs. The two most severe, but less common, forms of invasive disease are “necrotizing fasciitis” (infection of fatty and muscle tissue) and “streptococcal toxic shock syndrome” (rapidly progressive infection causing hypotension/shock and trauma injuries). organs such as the kidneys, liver and lungs). Approximately 20% of patients with necrotizing fasciitis and 60% of those with toxic shock syndrome die. Only 10% to 15% of patients with other forms of invasive group A streptococcal disease die.

4- What is the incidence of invasive group A streptococcal disease?

Each year, approximately 10,000 to 15,000 cases of invasive disease occur in the United States, resulting in more than 2,000 deaths. The US Centers for Disease Control and Prevention estimates that there are between 500 and 1,500 cases of necrotizing fasciitis and between 2,000 and 3,000 cases of toxic shock syndrome. In contrast, there are several million cases of strep throat and impetigo annually.

5- Why does invasive group A streptococcal disease occur?

Invasive group A streptococcal infections occur when the bacteria get past the defenses of the infected person. This can happen when a person has sores or other wounds on the skin, allowing bacteria to enter the tissue. Health conditions that lower a person’s immunity to infection also increase the likelihood of invasive disease. Additionally, there are certain varieties of Streptococcus pyogenes that can cause more serious illnesses than those caused by other varieties. The reason why certain varieties cause more serious illness is not entirely clear, but may be related to the production of substances (toxins) that cause shock and damage to organs and enzymes that cause tissue destruction.

6- Who is most at risk for contracting invasive group A streptococcal disease?

Few people who come into contact with a virulent strain will develop invasive disease; Most people, however, will suffer from a common skin or throat infection and some may have no symptoms. Although healthy people can contract the invasive disease, the population at highest risk is made up of those who suffer from chronic diseases, such as cancer, diabetes and kidney dialysis, as well as those who use medications such as steroids. Likewise, cuts in the skin, such as surgical wounds or chickenpox, can provide an opportunity for bacteria to enter the body.

7- Can invasive group A streptococcal disease be treated?

Group A strep bacteria can be treated with common antibiotics. Penicillin is the medication used for mild and severe cases. In patients allergic to penicillin who have mild cases, erythromycin can be used, although some cases of occasional resistance have been recorded. Clindamycin can also be used to treat penicillin-allergic patients with a more severe attack of the disease; This medication can also be added to the treatment in cases of necrotizing fasciitis or toxic shock syndrome. There are other antibiotics that are also effective. In addition to antibiotics, care in an intensive care unit and in certain cases surgery are necessary for these diseases. Early treatment can reduce the risk of death even though, unfortunately, even appropriate therapy does not prevent death in all cases.

8- Should people who have been in contact with those with invasive group A streptococcal disease be tested and treated?

The risk of secondary cases of invasive disease among people with casual contact with a case of this disease is very low. There are occasional reports of close contacts, such as with family members, in whom the disease has developed into severe condition. In general, if household contacts are in good health, they should be monitored for the appearance of symptoms of infection, without requiring them to receive preventive treatment with antibiotics. However, preventive antibiotics should be considered for people at higher risk for invasive disease if they become infected and under certain circumstances (i.e., those with diabetes, cancer, chronic heart disease, alcoholism, etc.). ).

9- What can be done to prevent invasive group A streptococcal infections?

The spread of all types of group A strep infections can be decreased by good hand washing, especially following coughing or sneezing, before preparing food, and following eating. Sore throat sufferers should see a doctor who can test them to determine if they have strep throat. If so, the person in question should not go to work, school, or daycare until 24 hours or more following taking an antibiotic. All wounds should be kept clean. Additionally, wounds need to be monitored for possible symptoms of infection, including increasing redness, swelling, and pain at the wound site. If these symptoms occur, especially in people who also have a fever, consult a doctor immediately.

10- What are the first symptoms of necrotizing fasciitis and streptococcal toxic shock syndrome?

The first signs and symptoms of necrotizing fasciitis include fever, sharp pain, and swelling and redness of the wound area. Early symptoms of streptococcal toxic shock may include fever, dizziness, confusion, hypotension, rash, and abdominal pain.

Source GCBA CLARÍN There are certain factors that make it more common for a condition to go from being primary or moderate to a serious invasive infection (in the blood, organs and bones). The bacteria begins to circulate at the end of winter and throughout spring. Suffer from immune problems. Having recently had chickenpox. Skin and soft tissue infections. Having had recent viral infections. Invasive infections rarely follow pharyngitis. Through contact with nasal or throat secretions of infected people. Through infected skin lesions. CONTAGION SYMPTOMS RISK FACTORS IN CHILDREN High fever (more than 38°) Sore throat (difficulty swallowing) Skin rash TREATMENT WHEN IT WORKS There is no vaccine but it is easily treatable with antibiotics. Do not wait for the condition to worsen before consulting to the doctor. HOW TO PREVENT CONTAGION Wash your hands Cover your cough Airy environments How the bacteria works Streptococcus pyogenes is a bacteria that is associated with throat infections in children, although it can also occur in adults. F E M A M J J A S O D N
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