Streptococcal disease: Watch for Groups A and B
November 1, 1999 2 minutes read
Streptococcal disease: Watch for Groups A and B
You should be on the lookout for both forms of streptococcal disease in your ED: Group A and Group B, urges Paula Heitkemper, RN, BSN, CIC, an infection control practitioner at the University Hospital in Cincinnati. Here are updates on each:
• Group A streptococcal disease. This is also known as the flesh-eating bacteria’ and is found in necrotizing fasciitis," says Heitkemper.
Group A streptococcal invasive disease more commonly occurs with diabetics and sometimes following varicella zoster (chickenpox) in children, she says. "You won’t know which bacteria is responsible until culture reports return, but classic signs of a skin or soft tissue infection should be a heads up,’" Heitkemper notes. "Group A streptococcus is the bacteria that causes strep throat, rheumatic heart fever, pneumonia, toxic shock syndrome, impetigo, scarlet fever, and even puerperal fever in women postpartum."
The incubation period is short, usually from one to three days, notes Heitkemper. "But patients with untreated streptococcal pharyngitis may carry the organism in the pharynx for weeks or months."
In populations where impetigo is prevalent, Group A streptococci may be recovered from the normal skin for one to two weeks before skin lesions develop, Heitkemper advises. "Group A streptococcus provides us with an example of why it is good practice to wash your hands after patient contact."
• Group B streptococcal disease. This can also cause necrotizing fasciitis and toxic shock syndrome and has been seen increasingly recently. "Three cases of community-acquired fasciitis, one accompanied by toxic shock, caused by Group B streptococci occurred over 10 months in Ontario and Quebec," notes Heitkemper. "Only four other cases of group B streptococcal fasciitis have been reported in the literature over the past four decades."1
Reference
1. Gardam MA, Low DE, Saginur R, et al. Group B streptococcal necrotizing fasciitis and streptococcal toxic shock-like syndrome in adults. Arch Intern Med 1998; 158:1,704-1,708.
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