Recurrent streptococcal infections
Pro Research Analysisby 
Searched over 200M research papers
Recurrent Streptococcal Infections: Types and Risk Factors
Recurrent streptococcal infections can involve different Streptococcus groups, including group A (GAS), group B (GBS), and groups C and G (such as Streptococcus dysgalactiae). These infections can affect both children and adults, with certain populations—like infants, the elderly, and those with chronic illnesses—being at higher risk for recurrence 1234+1 MORE.
Group B Streptococcus (GBS) Recurrence in Infants and Adults
Recurrent GBS infections in infants are rare but can occur, especially in preterm and low birthweight babies. Most recurrences are due to the same bacterial strain, suggesting persistent colonization rather than new infection. Hypervirulent strains, such as clonal complex 17, are more commonly associated with recurrence. Breastfeeding and persistent mucosal colonization are recognized risk factors, but oral antibiotics to eliminate carriage have not proven effective 1689.
In adults, recurrent GBS infections are more common than previously thought, particularly among those with multiple health conditions. The most frequent sites of infection are the urinary tract, soft tissues, and bloodstream. Relapse with the same strain is more common than reinfection with a new strain 23.
Group A Streptococcus (GAS) and Recurrent Tonsillopharyngitis
Recurrent GAS tonsillopharyngitis is especially prevalent in children under 8 years old. Recurrence rates have increased over the decades, and penicillin treatment is associated with higher recurrence compared to cephalosporins or macrolides. Some children are more susceptible due to immune system differences, such as smaller germinal centers in tonsils, lower antibody responses, and specific HLA class II genetic profiles 57.
Streptococcus dysgalactiae and Recurrent Bacteremia
Recurrent bacteremia caused by Streptococcus dysgalactiae (groups C and G) is also documented. Most recurrences involve the same bacterial type, indicating persistent colonization rather than new infection. No specific clinical risk factors have been identified, and the most common presentation is skin and soft tissue infection .
Prevention and Management Strategies
For recurrent GAS pharyngotonsillitis, the use of oral probiotics containing Streptococcus salivarius and Streptococcus oralis has shown promise in reducing infection frequency, antibiotic use, and school absences in children . However, for GBS, especially in infants, there is no consensus on the best management approach, and eradicating colonization remains challenging 69.
Conclusion
Recurrent streptococcal infections are influenced by host factors (such as age, immune response, and comorbidities), bacterial strain characteristics, and persistent colonization. While recurrence is more common in certain populations and with specific strains, effective prevention and management remain areas for further research, especially for GBS in infants and adults. Probiotics may offer a new avenue for reducing recurrence in GAS infections, but more studies are needed to confirm their long-term benefits.
Sources and full results
Most relevant research papers on this topic
Clinical and microbiological characteristics of recurrent group B streptococcal infection among non-pregnant adults.
Recurrent group B streptococcal infections occur more often than previously thought, mainly in adults with a high comorbid index, and relapse is more common than new acquisition.
DOI
Relapsing Invasive Group B Streptococcal Infection in Adults
Recurrent group B streptococcal infection in adults is common, particularly in elderly and those with chronic illness, and may be caused by the same strain or reinfection with another strain.
Recurrent bacteremia with Streptococcus dysgalactiae: a case-control study.
Recurrent Streptococcus dysgalactiae bacteremia is not associated with clinical risk factors, but a high proportion of identical emm types indicates host-specific colonization.
A 5-year review of recurrent group B streptococcal disease: lessons from twin infants.
Persistent mucosal colonization with the original group B streptococcal strain, rather than new acquisition, is a key factor in recurrent invasive GBS disease in twin infants.
DOI