Gear RJ; Carter JC; Carapetis JR; Baird RW; Davis JS

Author(s)

Gear RJ

Carter JC

Carapetis JR

Baird RW

Davis JS

Publication Date

2015-01

Abstract

Invasive group A streptococcus (iGAS) disease is an important cause of mortality globally. The incidence of iGAS in Australia's tropical Northern Territory (NT) has been previously reported as 32.2/100 000 in Indigenous people for the period 1991-1996. We aimed to measure the incidence and severity of iGAS disease in the NT since this time. We collected demographic data for all GAS blood culture isolates over a 12-year period (1998-2009) from the three hospital laboratories serving the tropical NT. We then collected detailed clinical information from hospital records and databases for the subset of these patients who were admitted to Royal Darwin Hospital during 2005-2009. There were 295 confirmed cases of GAS bacteraemia over the study period, with a mean (SD) age of 42.1 (22.0) years, and 163 (55.0%) were male. The annual age-adjusted incidence was 15.2 (95% CI 13.4-16.9)/100 000 overall and 59.4 (95% CI 51.2-67.6) in Indigenous Australians. For 2005-2009, there were 123 cases with the most common focus of infection being skin/soft tissue [44 (35.6%)]; 29 patients (23.6%) required intensive care unit admission and 20 (16.3%) had streptococcal toxic shock syndrome. Antecedent sore throat or use of non-steroidal anti-inflammatory drugs was rare, but current or recent scabies, pyoderma and trauma were common. The incidence and severity of iGAS are high and increasing in tropical northern Australia, and urgent attention is needed to improve surveillance and the social determinants of health in this population. This study adds to emerging data suggesting increasing importance of iGAS in low- and middle-income settings globally.

Citation

Tropical medicine & international health : TM & IH 2015-01; 20(1): 40-7

Pubmed ID

https://pubmed.ncbi.nlm.nih.gov/25354844/?otool=iaurydwlib

Link

https://hdl.handle.net/10137/5544

Subject

Australia

Australie

Estreptococo grupo A

Indigenous

Indígenas

Northern Territory

Territoire du Nord

Territorio del Norte

bacteraemia

bacteriemia

bactériémie

group A streptococcus

indigène

streptocoque du groupe A

tropical

MESH subject

Adolescent

Adult

Aged

Child

Child, Preschool

Female

Humans

Incidence

Male

Middle Aged

Northern Territory

Oceanic Ancestry Group

Risk Factors

Streptococcal Infections

Young Adult

Streptococcus pyogenes

Title

Changes in the clinical and epidemiological features of group A streptococcal bacteraemia in Australia's Northern Territory.

Type of document

Journal Article

Entity Type

Publication

Author(s)	Gear RJ Carter JC Carapetis JR Baird RW Davis JS
Publication Date	2015-01
Abstract	Invasive group A streptococcus (iGAS) disease is an important cause of mortality globally. The incidence of iGAS in Australia's tropical Northern Territory (NT) has been previously reported as 32.2/100 000 in Indigenous people for the period 1991-1996. We aimed to measure the incidence and severity of iGAS disease in the NT since this time. We collected demographic data for all GAS blood culture isolates over a 12-year period (1998-2009) from the three hospital laboratories serving the tropical NT. We then collected detailed clinical information from hospital records and databases for the subset of these patients who were admitted to Royal Darwin Hospital during 2005-2009. There were 295 confirmed cases of GAS bacteraemia over the study period, with a mean (SD) age of 42.1 (22.0) years, and 163 (55.0%) were male. The annual age-adjusted incidence was 15.2 (95% CI 13.4-16.9)/100 000 overall and 59.4 (95% CI 51.2-67.6) in Indigenous Australians. For 2005-2009, there were 123 cases with the most common focus of infection being skin/soft tissue [44 (35.6%)]; 29 patients (23.6%) required intensive care unit admission and 20 (16.3%) had streptococcal toxic shock syndrome. Antecedent sore throat or use of non-steroidal anti-inflammatory drugs was rare, but current or recent scabies, pyoderma and trauma were common. The incidence and severity of iGAS are high and increasing in tropical northern Australia, and urgent attention is needed to improve surveillance and the social determinants of health in this population. This study adds to emerging data suggesting increasing importance of iGAS in low- and middle-income settings globally.
Citation	Tropical medicine & international health : TM & IH 2015-01; 20(1): 40-7
Pubmed ID	https://pubmed.ncbi.nlm.nih.gov/25354844/?otool=iaurydwlib
Link	https://hdl.handle.net/10137/5544
Subject	Australia Australie Estreptococo grupo A Indigenous Indígenas Northern Territory Territoire du Nord Territorio del Norte bacteraemia bacteriemia bactériémie group A streptococcus indigène streptocoque du groupe A tropical
MESH subject	Adolescent Adult Aged Child Child, Preschool Female Humans Incidence Male Middle Aged Northern Territory Oceanic Ancestry Group Risk Factors Streptococcal Infections Young Adult Streptococcus pyogenes
Title	Changes in the clinical and epidemiological features of group A streptococcal bacteraemia in Australia's Northern Territory.
Type of document	Journal Article
Entity Type	Publication

Changes in the clinical and epidemiological features of group A streptococcal bacteraemia in Australia's Northern Territory.

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