ICU Management of Invasive β-Hemolytic Streptococcal Infections

β-hemolytic streptococci (BHS) are a leading cause of invasive bacterial disease worldwide. They are subtyped based on the presence of the surface polysaccharide antigens and include Group A Streptococcus (GAS; Streptococcus pyogenes), Group B Streptococcus (GBS; Streptococcus agalactiae), and non-group A, non-group B Streptococci (NABS). Invasive BHS infection is defined as isolation from the normally sterile site in patients with a compatible clinical syndrome which include, but is not limited to, streptococcal toxic shock syndrome (STSS), Necrotizing soft tissue infection (NSTI), bacteremia, meningitis lower respiratory tract, musculoskeletal and puerperal/postpartum infections. Resuscitation, source control, and β-lactam therapy are the cornerstone of therapy.