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Watts V, Usdin M, Mearkle R, Sriskandan S, Cordery R, Millership S, Saliba V, Edmundson C, Pai A, Brown CS, Balasegaram S, Lamagni T, Decraene V. Antibiotic chemoprophylaxis for close contacts of invasive group A streptococcus in community settings: Evidence review. J Infect 2025; 90:106468. [PMID: 40089213 DOI: 10.1016/j.jinf.2025.106468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2024] [Revised: 02/24/2025] [Accepted: 03/04/2025] [Indexed: 03/17/2025]
Abstract
OBJECTIVES Revised UK guidelines for the management of contacts of invasive group A Streptococcus (iGAS) infection in community settings were published in December 2022. We present the findings of a narrative review which informed the public health recommendations around the provision of antibiotic chemoprophylaxis detailed in the updated guidelines. METHODS We conducted a literature review of studies reporting the risk of iGAS infection associated with specific risk factors. RESULTS There was strong epidemiological evidence for an increased risk of iGAS infection in contacts who are older individuals, post-partum women, neonates and individuals with chickenpox infection; evidence on the impact of influenza co-infection, injecting drug use or being homeless in increasing risk of iGAS infection was less robust. CONCLUSIONS The guidelines made recommendations to offer chemoprophylaxis to close contacts of iGAS cases who are aged ≥75 years, pregnant ≥37 weeks gestation, post-partum, neonates or those with a recent history of, or current chickenpox infection. Systematic data collection evaluating the use of chemoprophylaxis and other control measures is recommended.
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Affiliation(s)
- Vicky Watts
- UK Health Security Agency, Field Services North West, Liverpool L1 3DS, UK.
| | - Martine Usdin
- South London Health Protection Team, UK Health Security Agency, 10 South Colonnade, Canary Wharf, London E14 4PU, UK.
| | - Rachel Mearkle
- South East Health Protection Team, UK Health Security Agency, Chilton, Oxon OX11 0RQ, UK.
| | - Shiranee Sriskandan
- Department of Infectious Disease, Imperial College London, London, UK; Centre for Bacterial Resistance Biology, Imperial College London, London, UK; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK.
| | - Rebecca Cordery
- UK Health Security Agency, Immunisations and Vaccine Preventable Diseases Division, 61 Colindale Avenue, London NW9 5EQ, UK.
| | - Sally Millership
- UK Health Security Agency, 10 South Colonnade, Canary Wharf, London E14 4PU, UK.
| | - Vanessa Saliba
- UK Health Security Agency, Immunisations and Vaccine Preventable Diseases Division, 61 Colindale Avenue, London NW9 5EQ, UK.
| | - Claire Edmundson
- UK Health Security Agency, Blood Safety, Hepatitis, STI and HIV Division, 61 Colindale Avenue, London NW9 5EQ, UK.
| | - Anjali Pai
- South East Health Protection Team, UK Health Security Agency, Chilton, Oxon OX11 0RQ, UK.
| | - Colin S Brown
- UK Health Security Agency, Healthcare Associated Infections, Fungal, Antimicrobial Resistance, Antimicrobial Use & Sepsis, 61 Colindale Avenue, London NW9 5EQ, UK.
| | - Sooria Balasegaram
- UK Health Security Agency, Field Services South East and London, 10 South Colonnade, Canary Wharf, London E14 4PU, UK.
| | - Theresa Lamagni
- UK Health Security Agency, Healthcare Associated Infections, Fungal, Antimicrobial Resistance, Antimicrobial Use & Sepsis, 61 Colindale Avenue, London NW9 5EQ, UK.
| | - Valerie Decraene
- UK Health Security Agency, Field Services North West, Liverpool L1 3DS, UK.
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Davies HD, Jackson MA, Rice SG, Byington CL, Maldonado YA, Barnett ED, Campbell JD, Lynfield R, Munoz FM, Nolt D, Nyquist AC, O’Leary S, Rathore MH, Sawyer MH, Steinbach WJ, Tan TQ, Zaoutis TE, LaBella CR, Brooks MA, Canty GS, Diamond A, Hennrikus W, Logan K, Moffatt KA, Nemeth B, Pengel B, Peterson A, Stricker P, COMMITTEE ON INFECTIOUS DISEASES, COUNCIL ON SPORTS MEDICINE AND FITNESS. Infectious Diseases Associated With Organized Sports and Outbreak Control. Pediatrics 2017; 140:peds.2017-2477. [PMID: 28947608 DOI: 10.1542/peds.2017-2477] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Participation in organized sports has a variety of health benefits but also has the potential to expose the athlete to a variety of infectious diseases, some of which may produce outbreaks. Major risk factors for infection include skin-to-skin contact with athletes who have active skin infections, environmental exposures and physical trauma, and sharing of equipment and contact with contaminated fomites. Close contact that is intrinsic to team sports and psychosocial factors associated with adolescence are additional risks. Minimizing risk requires leadership by the organized sports community (including the athlete's primary care provider) and depends on outlining key hygiene behaviors, recognition, diagnosis, and treatment of common sports-related infections, and the implementation of preventive interventions.
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Affiliation(s)
- H. Dele Davies
- Pediatric Infectious Diseases and Public Health, University of Nebraska Medical Center, Omaha, Nebraska
| | - Mary Anne Jackson
- Infectious Diseases, Children’s Mercy Kansas City and Department of Pediatrics, School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri; and
| | - Stephen G. Rice
- Sports Medicine, Jersey Shore University Medical Center and Department of Pediatrics, Robert Wood Johnson Medical School, Rutgers University, Neptune, New Jersey
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Abstract
Infections occur in childhood and adolescent athletes just as they do in all children and adolescents. Because of the sports environment, and in some instances the sport itself, athletes can be prone to infections that will alter their athletic performance or present risks to other athletes. Recognition of the infectious risks related to sports and the options for their treatment or, better yet, prevention, can help young athletes perform to their utmost potential.
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Affiliation(s)
- E Stephen Buescher
- Center for Pediatric Research, Eastern Virginia Medical School, Children's Hospital of The King & Daughters, Norfolk 23510, USA.
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Janda JM, Abbott SL, Brenden RA. Overview of the etiology of wound infections with particular emphasis on community-acquired illnesses. Eur J Clin Microbiol Infect Dis 1997; 16:189-201. [PMID: 9131321 DOI: 10.1007/bf01709581] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Wound cultures represent a general catchall category for a group of extremely diverse anatomic samples that range from superficial specimens of cutaneous structures (folliculitis, cellulitis) to specimens revealing invasive infections involving deep fascial planes and muscle (myonecrosis). Because of the complex nature of these infective processes, the terminology associated with such infections is often imprecise and confusing. Wounds are the result of trauma, either intentionally or accidentally induced. Nosocomial wound infections result primarily from surgical procedures, the development of pressure sores, or catheterization. Community-acquired wound infections are often preceded by injuries resulting from occupational exposure or recreational activities and are associated with a greater diversity of microorganisms due to the exposure of open wounds to inhabitants of the microbial biosphere. This review provides a general overview of the categories of wound infections and describes their acquisition and clinical significance. Particular emphasis is placed on selected community-acquired wound infections and the etiologic agents associated with such conditions.
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Affiliation(s)
- J M Janda
- Microbial Diseases Laboratory, Division of Communicable Disease Control, California Department of Health Services, Berkeley 94704, USA
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