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The epidemiology of invasive group A streptococcal disease in Victoria, Australia
Author(s) -
O’Grady KerryAnn F,
Kelpie Loraine,
Andrews Ross M,
Curtis Nigel,
Nolan Terence M,
Selvaraj Gowri,
Passmore Jonathan W,
Oppedisano Frances,
Carnie John A,
Carapetis Jonathan R
Publication year - 2007
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2007.tb01054.x
Subject(s) - medicine , case fatality rate , necrotising fasciitis , epidemiology , incidence (geometry) , clindamycin , penicillin , population , public health , erythromycin , streptococcus pyogenes , attack rate , pediatrics , fasciitis , surgery , antibiotics , environmental health , pathology , microbiology and biotechnology , biology , physics , genetics , bacteria , optics , staphylococcus aureus
Objective: To estimate the incidence and severity of invasive group A streptococcal infection in Victoria, Australia. Design: Prospective active surveillance study. Setting: Public and private laboratories, hospitals and general practitioners throughout Victoria. Patients: People in Victoria diagnosed with group A streptococcal disease notified to the surveillance system between 1 March 2002 and 31 August 2004. Main outcome measure: Confirmed invasive group A streptococcal disease. Results: We identified 333 confirmed cases: an average annualised incidence rate of 2.7 (95% CI, 2.3–3.2) per 100 000 population per year. Rates were highest in people aged 65 years and older and those younger than 5 years. The case‐fatality rate was 7.8%. Streptococcal toxic shock syndrome occurred in 48 patients (14.4%), with a case‐fatality rate of 23%. Thirty cases of necrotising fasciitis were reported; five (17%) of these patients died. Type 1 (23%) was the most frequently identified emm sequence type in all age groups. All tested isolates were susceptible to penicillin and clindamycin. Two isolates (4%) were resistant to erythromycin. Conclusion: The incidence of invasive group A streptococcal disease in temperate Australia is greater than previously appreciated and warrants greater public health attention, including its designation as a notifiable disease.