Streptococcus pyogenes infections

Recently, the National Ministry of Health issued an alert regarding the increase in severe Streptococcus pyogenes infections, with 118 cases and 16 deaths reported so far in 2023.

What is Streptococcus pyogenes?

It is a bacterium also known as group A streptococcus, which is commonly found in the throat and on the skin. In general, it causes mild illnesses such as tonsillitis, scarlet fever, and impetigo. However, in certain cases, it can cause much more serious and life-threatening illnesses, such as invasive disease, necrotizing cellulitis, and streptococcal toxic shock syndrome.

Why does invasive streptococcal disease occur?

Severe forms of this disease occur when, for some reason, the bacteria overwhelm the patient's defenses. This may be due to skin lesions or chronic diseases such as diabetes, chronic renal failure, corticosteroid use, or immunosuppression. There are also subgroups of streptococci that can produce a toxin that causes Toxic Shock Syndrome.

What is the risk of contracting invasive streptococcal disease?

First and foremost, we must emphasize that very few Streptococcus pyogenes infections develop into invasive forms. As mentioned previously, the population at highest risk consists of those suffering from chronic diseases such as cancer, diabetes, and kidney dialysis, as well as those who use medications such as steroids.

Can invasive group A streptococcal disease be treated?

Fortunately, this bacterium is very sensitive to many antibiotics, with penicillin being the treatment of choice. There are useful alternatives for patients who are allergic to this antibiotic. In some severe cases, the use of complementary treatments with immunoglobulins may be considered.

Should people who have been in contact with those suffering from invasive streptococcal disease be tested and treated?

As mentioned previously, the risk of developing a severe form of invasive disease is very low, so contacts should only be monitored clinically and evaluated if any symptoms appear. Antibiotics are not routinely used as a preventive measure.

Is there a way to prevent invasive group A streptococcal infections?

There is no vaccine for this disease. It is important to remember to follow normal hygiene rules such as washing your hands, especially after coughing or sneezing, before preparing food, and before and after eating. Anyone with tonsillitis should consult a doctor immediately. If a swab test confirms streptococcal infection, they should not go to work, school, or daycare until at least 24 hours after taking an antibiotic. Any skin lesions should be monitored, and the appearance of inflammation, redness, severe pain, and/or fever should be a warning sign to consult a doctor immediately.

Dr. Daniel Pryluka.

Infectious disease physician.