Management of invasive group A streptococcal infections
Management of invasive group A streptococcal infections
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DOI：
10.1016/j.jinf.2014.08.005
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发表时间：
2014-11-01
影响因子：
28.2
通讯作者：
Carapetis, Jonathan R.
中科院分区：
文献类型：
--
作者：
Waddington, Claire S.;Snelling, Thomas L.;Carapetis, Jonathan R.
儿童侵袭性A组链球菌（GAS）疾病包括深部软组织感染、菌血症、菌血症性肺炎、脑膜炎和骨髓炎。由GAS表达的毒素和超级抗原可以通过触发压倒性的全身炎症反应使感染复杂化，称为链球菌中毒性休克综合征（STSS）。GAS疾病的发作和进展可能很快，相关死亡率很高。及时的抗生素治疗和感染组织的早期手术清创是必不可少的。静脉注射免疫球蛋白和高压治疗的辅助治疗可能会改善严重疾病的预后。医院暴发和密切个人接触者继发病例并不罕见;感染控制措施和考虑对高危人群预防性使用抗生素是疾病控制的重要方面。为了减少GAS疾病的全球负担的很大一部分，需要一种可负担得起的GAS疫苗，其对多种菌株有效。皇冠版权所有（C）2014由爱思唯尔有限公司代表英国感染协会出版。All rights reserved.
Invasive group A streptococcal (GAS) disease in children includes deep soft tissue infection, bacteraemia, bacteraemic pneumonia, meningitis and osteomyelitis. The expression of toxins and super antigens by GAS can complicate infection by triggering an overwhelming systemic inflammatory response, referred to as streptococcal toxic shock syndrome (STSS). The onset and progression of GAS disease can be rapid, and the associated mortality high. Prompt antibiotics therapy and early surgical debridement of infected tissue are essential. Adjunctive therapy with intravenous immunoglobulin and hyperbaric therapy may improve outcomes in severe disease. Nosocomial outbreaks and secondary cases in close personal contacts are not uncommon; infection control measures and consideration of prophylactic antibiotics to those at high risk are important aspects of disease control. To reduce a substantial part of the global burden of GAS disease, an affordable GAS vaccine with efficacy against a broad number of strains is needed. Crown Copyright (C) 2014 Published by Elsevier Ltd on behalf of The British Infection Association. All rights reserved.