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Residents of long-term care facilities are at increased risk for disease and death from group A Streptococcus

Early recognition of group A Streptococcus (GAS) infections in long-term care facility (LTCF) residents is important as these infections can rapidly progress and can result in death in this population.

GAS can cause a spectrum of syndromes and severity of infections in residents of LTCFs. Some of these infections can rapidly progress within a matter of hours to days. Cellulitis and wound infections are the most common types of GAS infections among older adults and among residents of LTCFs. Less common but more severe GAS infections include bacteremia (bloodstream infection), pneumonia, septic arthritis (infection of a joint), necrotizing fasciitis, and streptococcal toxic shock syndrome (STSS).

Risk increases with age

Among adults, rates of invasive GAS infection increase with age.1 For example, the invasive GAS infection rates for adults in 2020 are as follows:

  • 8.3 cases per 100,000 population among people aged 50–64 years
  • 10.4 cases per 100,000 population among people aged 65–74 years
  • 11.2 cases per 100,000 population among people aged 75–84 years
  • 15.2 cases per 100,000 population among people aged 85 years or older

Death rates from invasive GAS infections also increase with age, with the highest rates seen among adults aged 65 years or older. Approximately 14% of people aged 65 years or older die from their invasive GAS infection.2

Risk is greater compared to adults living in the community

Older adults living in LTCFs are at even higher risk of GAS infection and death compared to older adults living in the community.3,4 Compared to age-matched adults living in the community, residents of LTCFs have a 3- to 8-fold higher incidence of invasive GAS infections and are 1.5 times more likely to die from GAS infections.4

  1. Nelson G, Pondo T, Toews KA, et al. Epidemiology of invasive group A streptococcal infections in the United States, 2005–2012. Clin Infect Dis. 2016;63(4):478–86.
  2. Centers for Disease Control and Prevention. Active Bacterial Core Surveillance Bact Facts Interactive Data Dashboard, Emerging Infections Program Network, Group A Streptococcus. Available at ABCs Bact Facts Interactive Data Dashboard | CDC.
  3. Jordan HT, Richards CL, Burton DC, et al. Group A streptococcal disease in long-term care facilities: Descriptive epidemiology and potential control measures. Clin Infect Dis. 2007;45(6):742–52.
  4. Thigpen MC, Richards CL, Lynfield R, et al. Invasive group A streptococcal infection in older adults in long-term care facilities and the community, United States, 1998–2003. Emerg Infect Dis. 2007;13(12):1852–9.