Smith A, Lamagni T L, Oliver I, Efstratiou A, George R C, Stuart J M
Health Protection Agency, Centre for Infections, London, UK.
Lancet Infect Dis. 2005 Aug;5(8):494-500. doi: 10.1016/S1473-3099(05)70190-0.
Group A streptococci (Streptococcus pyogenes) causes a wide range of illnesses from non-invasive disease--eg, pharyngitis--to more severe invasive infections--eg, necrotising fasciitis and toxic shock-like syndrome. There remains uncertainty about the risk of secondary cases of invasive disease occurring among close contacts of an index case and how best to manage that risk. We do not consider that currently available evidence justifies the routine administration of chemoprophylaxis to close contacts. We suggest that the appropriate response should be to routinely inform all household contacts of a patient with invasive group A streptococcal disease about the clinical manifestations of invasive disease and to seek immediate medical attention if they develop such symptoms.
A组链球菌（化脓性链球菌）可引发一系列疾病，从非侵袭性疾病（如咽炎）到更严重的侵袭性感染（如坏死性筋膜炎和中毒性休克样综合征）。对于首例病例的密切接触者中发生侵袭性疾病继发病例的风险以及如何最佳管理该风险，仍存在不确定性。我们认为，目前可得的证据并不足以证明对密切接触者进行常规化学预防是合理的。我们建议，适当的应对措施应该是常规告知侵袭性A组链球菌病患者的所有家庭接触者侵袭性疾病的临床表现，并告知他们如果出现此类症状应立即就医。
