We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......

Outbreak of Group A Streptococcus Septicemia in Children:  Clinical, Epidemiologic, and Microbiological Correlates

Mary C. Wheeler, MA; Martha H. Roe; Edward L. Kaplan, MD; Patrick M. Schlievert, PhD; James K. Todd, MD
JAMA. 1991;266(4):533-537. doi:10.1001/jama.1991.03470040097029.
Text Size: A A A
Published online

Objective.  —To determine the epidemiologic, clinical, and microbiological features of group A streptococcus septicemia in children.

Design.  —A descriptive series of 34 cases over an 11-year period from 1980 through 1990.

Setting.  —An academically affiliated tertiary-care pediatric hospital, the principal referral center for the state of Colorado and surrounding states.

Participants.  —Thirty-four patients with positive blood cultures for group A streptococcus (33 medical records were available).

Main Outcome Measures.  —Yearly incidence and clinical features of cases; microbiological features of isolated organisms.

Results.  —There was a significant increase (P =.01) in the incidence of group A streptococcus bacteremia over an 11-year period, with 14 (41%) of these cases occurring in 1989 and 1990. Patients had a rapidly progressing illness, usually without preceding pharyngitis. The prominent M and T types were 1 (4) and 12 (4). Eleven (73%) of the 15 strains produced pyrogenic exotoxin B that significantly correlated with production of proteinase.

Conclusion.  —There appears to be an increase in group A streptococcus bacteremia in children that is associated with a strain phenotype that suggests a change in organism virulence.(JAMA. 1991;266:533-537)


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.