Epidemiology of Invasive Group A Streptococcal Infections in the United States, 2005-2012.
Clin Infect Dis
; 63(4): 478-86, 2016 08 15.
Article
em En
| MEDLINE
| ID: mdl-27105747
ABSTRACT
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.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Choque Séptico
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Infecções Estreptocócicas
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Streptococcus pyogenes
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Fasciite Necrosante
Tipo de estudo:
Incidence_studies
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Prognostic_studies
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Screening_studies
Limite:
Adolescent
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Adult
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Aged
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Female
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Humans
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Male
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Middle aged
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article