Video:Group A streptococcal infection

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Definition

Group A streptococcal infection, is an infection with group A streptococcus.[1]Infection may spread through direct contact with mucus or sores on the skin.[2]Treatment is done via antibiotics. Infection with GAS is an increasing problem, particularly in Africa.[3]

Signs and symptoms

The affected individual may have GAS either on skin or in throat and show no symptoms.[4] If symptomatic, then fever, sore throat, nausea will occur (though several other symptoms exist).[5]

Complications

Complications include acute rheumatic fever and post-streptococcal glomerulonephritis.[6] Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is another complication.[5][7]

Cause

The etiology of this infection finds that Streptococcus pyogenes is a species of Gram-positive, aerotolerant bacteria in the genus Streptococcus.These bacteria are extracellular, and made up of non-motile and non-sporing cocci that tend to link in chains. [8]

Mechanism

In terms of the mechanism of this infection one finds that an ability by group A streptococcus to fight off phagocytosis is apparently related to factor H and fibrinogen binding by M protein, as well as to disarming complement component C5a.[9]

Diagnosis

Diagnosis is by a swab of the affected area for laboratory testing. A Gram stain is performed to show Gram-positive cocci in chains. Then, the organism is cultured on blood agar with an added bacitracin antibiotic disk to show beta-hemolytic colonies and sensitivity for the antibiotic.[10][11]

Prevention

S. pyogenes infections are best prevented through effective hand hygiene.[12] No vaccines are currently available to protect against S. pyogenes infection, although research has been conducted into the development of one.[13]

Treatment

The treatment of choice is penicillin, and the duration of treatment is around 10 days.[14] Antibiotic therapy, using injected penicillin, has been shown to reduce the risk of acute rheumatic fever.[15]

Epidemiology

Environmental factors, such as less crowding and the increase of family living space, can account for the reduction in incidence and severity of group A streptococci.[16]

References

  1. "Group A Streptococcal (GAS) Infections: Background, Pathophysiology, Etiology". eMedicine. 17 October 2021. Retrieved 6 January 2023.
  2. "Disease Listing, Group A Streptococcal, General Info | CDC Bacterial, Mycotic Diseases". web.archive.org. 19 December 2007. Retrieved 6 January 2023.
  3. Carapetis, JR; Steer, AC; Mulholland, EK; Weber, M (November 2005). "The global burden of group A streptococcal diseases". The Lancet Infectious Diseases. 5 (11): 685–94. doi:10.1016/S1473-3099(05)70267-X. PMID 16253886.
  4. "Streptococcal Infections (Invasive Group A Strep) : Bureau of Communicable Disease : NYC DOHMH". web.archive.org. 6 November 2012. Retrieved 7 January 2023.
  5. 5.0 5.1 Newberger, Ryan; Gupta, Vikas (2022). "Streptococcus Group A". StatPearls. StatPearls Publishing. Archived from the original on 17 November 2020. Retrieved 7 January 2023.
  6. Goldman, Lee; Schafer, Andrew I. (16 August 2019). Goldman-Cecil Medicine E-Book. Elsevier Health Sciences. p. 1872. ISBN 978-0-323-55087-1. Retrieved 14 January 2023.
  7. Snelling, Thomas L; Carapetis, Jonathan R (2013). "Group A Streptococcus". Hunter's Tropical Medicine and Emerging Infectious Disease: 391–401. doi:10.1016/B978-1-4160-4390-4.00036-9. Archived from the original on 10 January 2023. Retrieved 9 January 2023.
  8. "Streptococcus pyogenes - Pathogen Safety Data Sheets". Government of Canada, Public Health Agency of Canada. 2001-09-26. Archived from the original on 2017-01-17. Retrieved 2023-01-06.
  9. Cunningham, M. W. (July 2000). "Pathogenesis of group A streptococcal infections". Clinical Microbiology Reviews. 13 (3): 470–511. doi:10.1128/CMR.13.3.470. ISSN 0893-8512. PMC 88944. PMID 10885988.
  10. Kellogg JA, Bankert DA, Elder CJ, Gibbs JL, Smith MC (September 2001). "Identification of Streptococcus pneumoniae revisited". J. Clin. Microbiol. 39 (9): 3373–5. doi:10.1128/jcm.39.9.3373-3375.2001. PMC 88350. PMID 11526182.
  11. Burdash NM, West ME (March 1982). "Identification of Streptococcus pneumoniae by the Phadebact coagglutination test". J. Clin. Microbiol. 15 (3): 391–4. doi:10.1128/JCM.15.3.391-394.1982. PMC 272105. PMID 7076811.
  12. "Group A Strep | Group A Streptococcus Diseases | GAS | CDCGroup A strep". web.archive.org. 4 June 2020. Retrieved 14 January 2023.
  13. Good MF, Batzloff MR, Pandey M (November 2013). "Strategies in the development of vaccines to prevent infections with group A streptococcus". Human Vaccines & Immunotherapeutics. 9 (11): 2393–7. doi:10.4161/hv.25506. PMC 3981849. PMID 23863455.
  14. Falagas ME, Vouloumanou EK, Matthaiou DK, Kapaskelis AM, Karageorgopoulos DE (2008). "Effectiveness and safety of short-course vs long-course antibiotic therapy for group a beta hemolytic streptococcal tonsillopharyngitis: a meta-analysis of randomized trials". Mayo Clin Proc. 83 (8): 880–9. doi:10.4065/83.8.880. PMID 18674472.
  15. HOUSER HB, WANNAMAKER LW, RAMMELKAMP CH, DENNY FW, BRINK WR, HAHN EO, DINGLE JH (1950). "Prophylaxis of acute rheumatic fever by treatment of the preceding streptococcal infection with various amounts of penicillin". J Lab Clin Med. 36 (5): 839. PMID 14784714.
  16. Quinn, Robert W. (1982). "Streptococcal Infections". Bacterial Infections of Humans: Epidemiology and Control. Springer US. pp. 525–552. ISBN 978-1-4757-1140-0. Retrieved 12 January 2023.