Streptococcal Invasive Disease - Group A, 2017: DCN - Minnesota Dept. of Health

Streptococcal Invasive Disease Group A, 2017

Invasive Group A streptococcal disease (GAS) is defined as GAS isolated from a usually sterile site such as blood, cerebrospinal fluid, or a wound when accompanied with necrotizing fasciitis or streptococcal toxic shock syndrome (STSS). Three hundred fifty-nine cases (6.2 cases per 100,000 population), including 34 deaths, were reported in 2017, compared to 277 cases and 24 deaths in 2017. The median age of cases was 60 years (range, newborn to 101 years). Fifty-seven percent of cases were residents of the metropolitan area. Allowing for multiple presentations per patient, 129 (36%) had cellulitis, 87 (24%) bacteremia without another focus of infection, 70 (19%) septic shock, 40 (11%) pneumonia, 36 (10%) abscess, 30 (8%) septic arthritis and/or osteomyelitis, 19 (5%) necrotizing fasciitis, and 11 (3%) had STSS. Thirty-nine (11%) cases were residents of long-term care facilities. Sixteen facilities had a single case, six facilities had 2 or more cases including one facility that had 6 cases.

Three of the 17 facilities had 1 case in 2017, and additional cases in 2016 or 2018. The 34 deaths included 11 that presented with just septic shock; 6 bacteremia without another focus of infection; 6 cellulitis; 1 pneumonia; 3 both septic shock and pneumonia; 2 both pneumonia and cellulitis; 1 both septic shock and cellulitis; 1 with necrotizing fasciitis and septic shock; 1 pneumonia with necrotizing fasciitis and septic shock; 1 septic arthritis with septic shock and STSS; and 1 case with an unknown infection type. Of the 34 deaths, the most frequently reported underlying conditions were diabetes (12), current smoker (10), chronic kidney disease (8), current alcohol abuse (8), cirrhosis (7), heart failure (7), chronic obstructive pulmonary disease (6), obesity (5), chronic skin breakdown (4), and current non-injecting drug use (4). Twenty-six fatal cases had two or more underlying conditions, and 2 had none reported.

Updated Thursday, 24-Jan-2019 08:38:00 CST