CDC Tracks Invasive Group A Strep Infection Amidst Antibiotic Shortage

The CDC is monitoring invasive group A streptococcus (iGAS) infections after noticing high incidence rates despite other declining respiratory infections. The rising rates are cause for alarm, considering the current ongoing antibiotic shortages.

Data from the CDC suggests that iGAS infection rates decreased by 25% during the pandemic, the lowest rates since the late 1990s. However, since the days of lockdown, iGAS infections have risen alongside other respiratory illnesses. The only caveat is that iGAS cases have yet to decrease, although different respiratory disease rates, such as influenza and respiratory syncytial virus (RSV), have declined.

In 2022, respiratory infection rates rose before their regular season, including iGAS. The CDC noted unusually high rates of iGAS among pediatric patients and elderly individuals.

Group A strep is linked to strep throat, scarlet fever, impetigo, rheumatic fever, and post-streptococcal glomerulonephritis. Strep throat, one of the most common diseases, can cause fever, pain when swallowing, sore throat, swollen tonsils and lymph nodes, headache, digestive issues, and rash.

Invasive strep A infections include cellulitis, necrotizing fasciitis, pneumonia, and streptococcal toxic shock syndrome.

Antibiotics are one of the most common ways to treat strep throat and other infectious diseases caused by group A strep. However, supply chain issues have triggered a shortage of many drugs, including amoxicillin, one of the most commonly prescribed antibiotics.

Although the severity of symptoms and the need for antibiotic treatment may vary, some severe cases of iGAS may be fatal. Based on reported cases in the past five years, iGAS contributes to 1,500–2,300 deaths in the United States annually.

With increasing risks and limited access to standard treatment, the CDC recommends that individuals monitor themselves for common strep A symptoms. Additionally, remaining up to date on vaccinations can help reduce the risk of invasive infection.

Providers should offer information to their patients on iGAS and vaccines that can minimize disease risk. Beyond that, healthcare professionals are expected to monitor patients with symptoms and conduct the appropriate testing, including bacterial cultures, when necessary. If patients cannot obtain amoxicillin due to the shortage, pediatricians can refer to the American Academy of Pediatrics’ list of alternative antibiotic options.