Bassetti Matteo, Giacobbe Daniele Roberto, Larosa Barbara, Lamarina Annaflavia, Vena Antonio, Brucci Giorgia
Department of Health Sciences (DISSAL), University of Genoa.
Clinica Malattie Infettive, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy.
Curr Opin Infect Dis. 2025 Apr 1;38(2):114-121. doi: 10.1097/QCO.0000000000001095. Epub 2025 Jan 24.
To discuss skin and soft tissue infections (SSTIs) caused by group A Streptococcus (GAS) by focusing on their pathogenesis, clinical manifestations, and management strategies.
GAS is responsible for a wide range of infections from mild disease to severe fatal invasive infections with high mortality rates. Invasive GAS (iGAS) infections affect both young and old individuals and account for 1.8 million cases worldwide, with a mortality rate of up to 20%. In addition, conditions resulting by immune responses triggered by GAS also contribute to GAS-associated morbidity, and should not be overlooked. GAS has the ability to produce a wide set of virulence factors which contribute to its pathogenicity and its ability to colonize different body site and subsequently cause invasive infections. Management of SSTIs caused by GAS is challenging due to the risk of rapid progression and the risk of developing complications.
During the COVID-19 pandemic, a relevant increase in iGAS infections has been registered. A constantly updated knowledge of the clinical presentation of iGAS infections is thus necessary to reduce their high mortality rates. Proper recognition and treatment of iGAS infections remain crucial.
通过关注A组链球菌（GAS）引起的皮肤和软组织感染（SSTIs）的发病机制、临床表现及管理策略进行讨论。
GAS可导致从轻度疾病到严重致命性侵袭性感染等广泛的感染，死亡率很高。侵袭性GAS（iGAS）感染影响年轻人和老年人，全球范围内有180万例病例，死亡率高达20%。此外，由GAS触发的免疫反应导致的病症也会导致与GAS相关的发病率增加，不容忽视。GAS能够产生多种毒力因子，这些因子有助于其致病性以及在不同身体部位定植并随后引起侵袭性感染的能力。由于GAS引起的SSTIs有快速进展的风险和发生并发症的风险，其管理具有挑战性。
在新冠疫情期间，iGAS感染有了显著增加。因此，为降低iGAS感染的高死亡率，持续更新对其临床表现的认识很有必要。对iGAS感染的正确识别和治疗仍然至关重要。
