Details:

Alternative Title:
Clin Infect Dis
Personal Author:
Nelson, George E. ; Pondo, Tracy ; Toews, Karrie-Ann ; Farley, Monica M. ; Lindegren, Mary Lou ; ... More +
Nelson, George E. ; Pondo, Tracy ; Toews, Karrie-Ann ; Farley, Monica M. ; Lindegren, Mary Lou ; Lynfield, Ruth ; Aragon, Deborah ; Zansky, Shelley M. ; Watt, James P. ; Cieslak, Paul R. ; Angeles, Kathy ; Harrison, Lee H. ; Petit, Susan ; Beall, Bernard ; Van Beneden, Chris A. Less -
Description:
Background

Invasive group A Streptococcus (GAS) infections are associated with significant morbidity and mortality rates. We report the epidemiology and trends of invasive GAS over 8 years of surveillance.

Methods

From January 2005 through December 2012, we collected data from the Centers for Disease Control and Prevention’s Active Bacterial Core surveillance, a population-based network of 10 geographically diverse US sites (2012 population, 32.8 million). We defined invasive GAS as isolation of GAS from a normally sterile site or from a wound in a patient with necrotizing fasciitis (NF) or streptococcal toxic shock syndrome (STSS). Available isolates were emm typed. We calculated rates and made age- and race-adjusted national projections using census data.

Results

We identified 9557 cases (3.8 cases per 100 000 persons per year) with 1116 deaths (case-fatality rate, 11.7%). The case-fatality rates for septic shock, STSS, and NF were 45%, 38%, and 29%, respectively. The annual incidence was highest among persons aged ≥65 years (9.4/100 000) or <1 year (5.3) and among blacks (4.7/100 000). National rates remained steady over 8 years of surveillance. Factors independently associated with death included increasing age, residence in a nursing home, recent surgery, septic shock, NF, meningitis, isolated bacteremia, pneumonia, emm type 1 or 3, and underlying chronic illness or immunosuppression. An estimated 10 649–13 434 cases of invasive GAS infections occur in the United States annually, resulting in 1136–1607 deaths. In a 30-valent M-protein vaccine, emm types accounted for 91% of isolates.

Conclusions

The burden of invasive GAS infection in the United States remains substantial. Vaccines under development could have a considerable public health impact.


Subject:
[+]
Article
Epidemiology
Group A Streptococcus
Streptococcal Toxic Shock Syndrome
Surveillance
Vaccine

Source:
Clin Infect Dis. 63(4):478-486.
Pubmed ID:
27105747
Pubmed Central ID:
PMC5776658
Document Type:
Journal Article
Funding:
CC999999/Intramural CDC HHS/United States
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:3b4c1bbf89cb4eb465564766cd85515823e2564f2c9106da69fbaa37cab33d0d
File Type:

Supporting Files

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