Flesh-eating bacteria: Streptococcus pyogenes

The Streptococcus pyogenes, commonly known as “flesh-eating bacteria,” is part of the normal human flora, found on the skin, in the nasopharyngeal region, and in the anogenital area of many people. Most individuals remain asymptomatic; however, under certain circumstances, it can cause severe and invasive infections. This bacterium can occur at any age, but research over the past decades indicates that young adults, particularly those aged 20-35, are at the highest risk. Streptococcus pyogenes is highly prevalent and causes a range of diseases, from relatively mild throat infections to severe, life-threatening conditions.

The bacteria spread from person to person, primarily through respiratory droplets, but also through other means such as skin contact or using contaminated surfaces. Diseases caused by Streptococcus pyogenes encompass a wide spectrum, and symptoms can vary, making diagnosis and treatment challenging.

The occurrence of Streptococcus pyogenes

Streptococcus pyogenes is a Gram-positive, spherical bacterium that lives in humans as part of the normal gut and skin flora. It belongs to Group A, along with several other Streptococcus species, and is one of the most important pathogens regarding human diseases. Additionally, Group B Streptococcus agalactiae and members of the viridans group also play a role in the development of various infections.

Streptococcus pyogenes can be found not only on the skin but also in the nasopharyngeal region and around the genital area, where it usually remains harmless to most individuals. However, the bacterium spreads easily, especially via respiratory droplets when an infected person coughs or sneezes. Nasal secretions, saliva, and contaminated surfaces can all contribute to the pathogen’s spread. Asymptomatic carriers, who show no symptoms but still transmit the bacteria, play a significant role in the spread of infection.

Diseases caused by Streptococcus pyogenes

The diseases triggered by Streptococcus pyogenes encompass a wide range, from relatively mild throat infections to severe, life-threatening conditions. The bacterium is responsible for a significant portion of sore throats, but it can also cause many other infections. More severe forms include necrotizing soft tissue infections, postpartum infections, bloodstream infections, and pneumonia.

Necrotizing soft tissue infection, often referred to as “flesh-eating bacteria,” is one of the most dangerous forms. This infection affects the limbs and presents with sudden onset symptoms. The infection spreads rapidly and can cause severe tissue necrosis, potentially leading to limb amputations or death.

Pregnancy-related infections are also concerning as they can develop during the postpartum period and pose serious complications for both the mother and the infant. The occurrence of pneumonia is relatively rare, but when it does occur, it often presents alongside bloodstream infections, making the situation even more serious.

Causes of invasive Streptococcus pyogenes infections

Although Streptococcus pyogenes typically does not cause severe invasive infections, certain circumstances can significantly increase the risk. Research over the past decades shows that the 20-35 age group is the most affected, although the disease can occur at any age.

Several factors can contribute to the illness, including minor injuries, bruises, muscle strains, and certain medical conditions such as HIV infection, diabetes, or heart disease. Obesity and the use of corticosteroids can also increase the risk. The use of non-steroidal anti-inflammatory drugs (NSAIDs), surgeries, and the presence of open wounds can also contribute to the development of infection.

In cases where infection is suspected, it is crucial for patients to seek medical attention promptly, as early diagnosis and treatment are essential to avoid severe consequences.

Diagnosis and treatment process

The diagnosis of invasive infections caused by Streptococcus pyogenes is a complex process that involves a thorough assessment of the patient’s medical history and symptoms. If an infection is suspected, various microbiological samples must be collected, such as wound exudate, sputum, or blood samples, which are necessary for laboratory testing. Imaging studies can also help determine the extent of the infection.

Treatment typically involves antibiotics, with a combination of penicillin and clindamycin being the most common choice. If necessary, patients may require intensive care treatment and surgical interventions to remove infected tissues. The treatment plan is always devised by the medical team, and immediate intervention is necessary to stabilize the patient’s condition.

Prevention options

To prevent infections caused by Streptococcus pyogenes, it is essential to adhere to proper hygiene measures. Regular handwashing, disinfecting surfaces, and careful management of open wounds are all important steps in avoiding infection.

Proper management of risk factors, such as diabetes or heart disease, can also contribute to preventing infections. Antibiotic prophylaxis is only recommended for those at particularly high risk, such as pregnant women or patients who have recently undergone surgery. To prevent invasive Streptococcus pyogenes infections, it is important for everyone to be aware of the risk factors for infection and the available prevention options.