Group A streptococcal bacteremia in a community teaching hospital--1980-1989.
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 less than .02), less than 10,000/mm3 leukocytes (P less than .05); less than 80% segmented polymorphonuclear leukocytes and band forms (P less than .02), and hyperbilirubinemia (P less than .01). Neither prevalence nor severity of group A streptococcal bacteremia increased during the last 5 years of study.
Burkert
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Department of Internal Medicine, St. Elizabeth Hospital Medical Center, Youngstown, Ohio 44501-1790.
Watanakunakorn
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C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology* / Q000401:mortality; D002481:Cellulitis / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality; D002648:Child; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology* / Q000401:mortality; D004697:Endocarditis, Bacterial / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D011014:Pneumonia / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality; D012189:Retrospective Studies; D012621:Seasons; D013290:Streptococcal Infections / Q000453:epidemiology / Q000382:microbiology* / Q000401:mortality; D013297:Streptococcus pyogenes / Q000187:drug effects / Q000302:isolation & purification*