Invasive group A streptococcal infections in Florida.
BACKGROUND
Several previous studies of invasive Group A streptococcal (GAS) disease have been hindered by small sample sizes (< or = 100 patients) and limited generalizability.


METHODS
We conducted a population-based study of invasive GAS disease. The objectives of the study were to describe the clinical features of individuals who were hospitalized for invasive GAS disease and to identify risk factors for hospital mortality. The cases were 257 patients who were hospitalized throughout Florida during a 4-year period and reported to the Florida Department of Health. Logistic regression was used to calculate adjusted odds ratios (OR) for mortality and 95% confidence intervals (CI).


RESULTS
The overall mortality was 18% (41 of 228). Admission into an intensive care unit was a strong predictor of mortality (OR, 20.41; 95% CI, 6.41-64.96). Treatment with clindamycin reduced mortality in patients who had necrotizing fasciitis (OR, 0.11; 95% CI, 0.01-0.89) but not in patients who did not have necrotizing fasciitis (OR, 1.01; 95% CI, 0.31-3.33).


CONCLUSIONS
Clindamycin reduces mortality in patients with invasive GAS disease who have necrotizing fasciitis.
Mulla
Zuber D
ZD
Department of Epidemiology and Biostatistics, University of South Florida, Tampa, FL, USA. zmulla@utep.edu
Leaverton
Paul E
PE
Wiersma
Steven T
ST
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002981:Clindamycin / Q000627:therapeutic use; D005260:Female; D005431:Florida / Q000453:epidemiology; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013290:Streptococcal Infections / Q000453:epidemiology* / Q000382:microbiology* / Q000628:therapy; D013297:Streptococcus pyogenes / Q000302:isolation & purification*; D015996:Survival Rate
D000900:Anti-Bacterial Agents; D002981:Clindamycin