Beta-hemolytic group a streptococcal orthopaedic infections: Our institutional experience and review of the literature.

Group A streptococcal (GAS) infections have high morbidity and mortality due to toxin production and tissue invasion. We reviewed all orthopaedic GAS infections at our medical centre between January 2017 and April 2019. Median age was 56 years. At least 60% had a body mass index (BMI) of ≥30 kg/m2. Median Charlson comorbidity score was 3 (range 0–7). Clinical cure at 90 days was achieved in only 62%. All 4 patients with underlying orthopaedic hardware were cured. Toxin-neutralizing antibiotics and intravenous immunoglobulin were underutilized. Our review confirms poor outcomes from GAS orthopaedic infections without optimal management.