Invasive Group A Streptococcal Infections at Chula- longkorn University Hospital
CHUSANA SUANKRATAY, M.D., Ph.D.*, PONG PUN NUNTHAPISUD, M.Sc. **, HENRY WILDE, M.D.***
Affiliation : * Division of Infectious Diseases, Department of Medicine, * * National Streptococcal Reference Center, Department ofMicrobiology, Faculty of Medicine, Chulalongkom University, *** Queen Saovabha Memorial Institute, Bangkok 10330, Thailand.
To determine whether the incidence and pattern of group A Streptococcal (GAS) infec- tions in Thailand have paralleled those in the United States and Europe, we conducted a retro- spective study of invasive GAS infections at Chulalongkom University Hospital from 1995 to 1999. A total of 42 cases were identified. There were 18 males and 24 females (median age of 59 and 46 years, respectively). Most patients were in two age groups: 20-39 (33%) and 60-79 (38% ). Underlying conditions were present in 34 patients (81% ), including mostly chronic system diseases (50%), alcohol abuse (19%), diabetes mellitus (14%), connective tissue diseases (12%), immunosuppressive illnesses (12%), and human immunodeficiency virus infection (10%). The most common clinical presentations were skin and soft-tissue infections (31% ), primary bacteremia (29%), and arthritis (14%). Of these, 24 (57%) presented with toxic shock syndrome (TSS). Overall mortality rate was 33 per cent. All GAS but one isolate were susceptible to penicillin.
Keywords : Group A Streptococcal Infection, Toxic Shock Syndrome, Bacteremia
