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Original ArticleOpen Access
Invasive Streptococcal Group A Infection and Toxic Shock Syndrome in Songklanagarind Hospital
Tongyoo S 
,
Sithinamsuwan P ,
Apakupakul N ,
Chayakul P
,
Sithinamsuwan P ,
Apakupakul N ,
Chayakul P Background and Objectives : Streptococcal group A infection is reported as a medical
problem in several parts of the world. The most serious complication of this infection is strepto-
coccal toxic shock syndrome (STSS) which is associated with a very high mortality rate. The present
study aimed to determine the clinical manifestations, including underlying conditions, mortality and
prognostic factors, of invasive streptococcal group A infection and STSS from southern Thailand
(Songklanagarind Hospital).
Method :The medical records of infected patients from January 1, 1995 to June 30, 1999
were reviewed retrospectively. Criteria for diagnosis of STSS were as follows (JAMA 1993). Prog-
nostic factors were analyzed by logistic regression model.
Result : 176 cases of STSS and streptococcal group A infection, 89.9 per cent were com-
munity acquired infections. About 70 per cent of the infected patients had previous underlying con-
ditions, the most common was cancer. The commonest site of infection was the skin and soft tissue
(80.1% ). The total mortality rate from streptococcal group A infection was 9.1 per cent. STSS was
identified in 12 patients (6.8%), with a 50 per cent mortality rate. Prognostic factors for mortality
in this infection were diabetic mellitus (odds ratio 9.67, p
problem in several parts of the world. The most serious complication of this infection is strepto-
coccal toxic shock syndrome (STSS) which is associated with a very high mortality rate. The present
study aimed to determine the clinical manifestations, including underlying conditions, mortality and
prognostic factors, of invasive streptococcal group A infection and STSS from southern Thailand
(Songklanagarind Hospital).
Method :The medical records of infected patients from January 1, 1995 to June 30, 1999
were reviewed retrospectively. Criteria for diagnosis of STSS were as follows (JAMA 1993). Prog-
nostic factors were analyzed by logistic regression model.
Result : 176 cases of STSS and streptococcal group A infection, 89.9 per cent were com-
munity acquired infections. About 70 per cent of the infected patients had previous underlying con-
ditions, the most common was cancer. The commonest site of infection was the skin and soft tissue
(80.1% ). The total mortality rate from streptococcal group A infection was 9.1 per cent. STSS was
identified in 12 patients (6.8%), with a 50 per cent mortality rate. Prognostic factors for mortality
in this infection were diabetic mellitus (odds ratio 9.67, p
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