Increase in Invasive Group A Streptococcal Disease and Emergence of Mucoid Strains in a Pediatric Population: February–June 2017

Details

• Alternative Title:
  Open Forum Infect Dis
• Personal Author:
  Walker, Lorne W ; Montoya, Lindsay ; Chochua, Sopio ; Beall, Bernard ; Green, Michael
• Description:
  Background
  
  Infection with group A Streptococcus (GAS) can cause severe systemic and locally invasive disease. Invasive group A streptococcal (iGAS) disease incidence varies both seasonally and year-to-year, and it may exhibit clustered outbreaks. We observed an upswing in iGAS cases at a tertiary care Children’s Hospital, prompting further characterization of local iGAS disease.
  
  Methods
  
  Cases of iGAS disease were abstracted from the medical record by manual chart review of all positive screening tests and cultures for GAS over a 4-year span. Incidence rates per 1000 hospital admissions and per 100 positive GAS tests were calculated and compared. Selected isolates were further characterized by whole-genome sequencing.
  
  Results
  
  Significant year-to-year differences in per-admission iGAS incidence rate were observed in February and June, although per-positive test incidence rates were not significantly different. Whole-genome sequencing revealed 2 dominant serotypes—emm3 and emm6—with high rates of mucoid phenotype and systemic bacteremia.
  
  Conclusions
  
  We document a significant but transient increase in iGAS disease incidence in 2 months of 2017. Genome sequencing revealed 2 dominant serotypes associated with mucoid phenotypes and severe disease, highlighting the dynamic nature of iGAS disease pattern.
  
  
• Subjects:
  Bacteremia Group A Streptococcus IGAS Invasive Disease Major Article Mucoid
• Source:
  Open Forum Infect Dis. 2019; 6(7)
• Pubmed ID:
  31281869
• Pubmed Central ID:
  PMC6602792
• Document Type:
  Journal Article
• Volume:
  6
• Issue:
  7
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:ed4c44f085c61a9a761eb61b075054c19ff09266ef37943026c4f11ebffdc7ae
• Download URL:
  https://stacks.cdc.gov/view/cdc/90982/cdc_90982_DS1.pdf
• File Type:
  [PDF - 443.99 KB ]