Increased Risk for Serious Outcomes

Key points

  • Group A Streptococcus (GAS) can cause serious infections.
  • Early recognition of GAS in long-term care facility (LTCF) residents is important.
  • These infections can rapidly progress and can result in death in this population.
A healthcare provider checks on the blood pressure of a resident of a long-term care facility.

Overview

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.

Keep Reading: Types of GAS Infections

Most common

Cellulitis and wound infections are the most common types of GAS infections among older adults and among residents of LTCFs.

Less common

Less common but more severe GAS infections include:

Age-based risk

Generally, rates of invasive GAS infection among adults increase with age.1

For example, the invasive GAS infection rates for adults in 2020 were:

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

The COVID-19 pandemic temporarily interrupted this pattern in 2021. Adults 50 through 64 years old had higher rates of invasive GAS infection compared to adults 65 through 74 years old. However, current data indicate rates have returned to the normal pattern.

Death rates from invasive GAS infections also increase with age. The highest rates are seen among adults aged 65 years or older. Approximately 15% of people aged 65 years or older die from their invasive GAS infection2.

Setting-based risk

Older adults living in LTCFs are at higher risk of GAS infection and death compared to those living in the community34. Compared to age-matched adults living in the community, LTCF residents have a 3- to 8-fold higher incidence of invasive GAS infections. In addition, they are 1.5 times more likely to die from GAS infections4.

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Content Source:
National Center for Immunization and Respiratory Diseases; Division of Bacterial Diseases
  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.