Group A beta-hemolytic streptococcal bacteremia and intravenous substance abuse. A growing clinical problem?
Over an 18-month period, the incidence of group A beta-hemolytic streptococcal bacteremia rose from an average of 2.5 per 10,000 patient discharges to 17.9. A retrospective analysis was performed comparing patients with group A beta-hemolytic streptococcal bacteremia during this 18-month period with those who presented over the preceding 36 months. Most of the increased incidence was attributable to individuals hospitalized with a diagnosis of drug addiction who had concomitant soft-tissue infection, although the absolute number of hospitalized drug addicts did not change during this interval. No common or distinctive group A streptococcal serotypic patterns were discovered. This experience suggests that group A beta-hemolytic streptococcal bacteremia and soft-tissue infection may present in epidemic fashion among parenteral drug addicts in the absence of a common source.
Department of Medicine, Episcopal Hospital, Philadelphia, Pa.
A L
AL
Lentnek
O
O
Giger
E
E
O'Rourke
D000328:Adult; D016000:Cluster Analysis; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D015143:Philadelphia / Q000453:epidemiology; D012189:Retrospective Studies; D018805:Sepsis / Q000453:epidemiology / Q000209:etiology*; D013290:Streptococcal Infections / Q000453:epidemiology / Q000209:etiology*; D013297:Streptococcus pyogenes / Q000302:isolation & purification; D015819:Substance Abuse, Intravenous / Q000150:complications*