Group A Streptococcal Bacteremia in a Community Teaching Hospital-- 1980-1989

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Abstract
This report reviews 45 episodes of group A streptococcal bacteremia during 1980–1989 in a large hospital; 24 episodes occurred in the first 5 years of study (1980–1984) and 21 in the last 5 years (1985–1989). Four episodes were nosocomial. The remaining 41 episodes were community acquired; of these episodes, 12 occurred in patients who were transferred from nursing homes. There was a definite seasonal predominance (84%) during November–June. All but three patients had chronic underlying conditions. The major portals of entry were the skin and lungs, and the main types of infection were primary septicemia, cellulitis and soft-tissue infection, pneumonia, and infective endocarditis. The overall mortality rate was 24%; 20% of the deaths were due to infection. Factors that adversely influenced mortality were septic shock (P < .02), 3 leukocytes (P < .05); P < .02), and hyperbilirubinemia (P < .01). Neither prevalence nor severity of group A streptococcal bacteremia increased during the last 5 years of study.

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