Abstract
| Original language | English |
|---|---|
| Pages (from-to) | 1018-1027 |
| Number of pages | 10 |
| Journal | Epidemiology and Infection |
| Volume | 144 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - Apr 2016 |
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High burden of invasive group A streptococcal disease in the Northern Territory of Australia. / Boyd, R; Patel, Mahomed Said; Currie, Bart; Holt, Deborah; Harris, Tegan; Krause, Vicki.
In: Epidemiology and Infection, Vol. 144, No. 5, 04.2016, p. 1018-1027.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - High burden of invasive group A streptococcal disease in the Northern Territory of Australia
AU - Boyd, R
AU - Patel, Mahomed Said
AU - Currie, Bart
AU - Holt, Deborah
AU - Harris, Tegan
AU - Krause, Vicki
PY - 2016/4
Y1 - 2016/4
N2 - Although the incidence of invasive group A streptococcal disease in northern Australia is very high, little is known of the regional epidemiology and molecular characteristics. We conducted a case series of Northern Territory residents reported between 2011 and 2013 with Streptococcus pyogenes isolates from a normally sterile site. Of the 128 reported episodes, the incidence was disproportionately high in the Indigenous population at 69·7/100 000 compared to 8·8/100 000 in the non-Indigenous population. Novel to the Northern Territory is the extremely high incidence in haemodialysis patients of 2205·9/100 000 population; and for whom targeted infection control measures could prevent transmission. The incidences in the tropical north and semi-arid Central Australian regions were similar. Case fatality was 8% (10/128) and streptococcal toxic shock syndrome occurred in 14 (11%) episodes. Molecular typing of 82 isolates identified 28 emm types, of which 63 (77%) were represented by four emm clusters. Typing confirmed transmission between infant twins. While the diverse range of emm types presents a challenge for effective coverage by vaccine formulations, the limited number of emm clusters raises optimism should cluster-specific cross-protection prove efficacious. Further studies are required to determine effectiveness of chemoprophylaxis for contacts and to inform public health response.
AB - Although the incidence of invasive group A streptococcal disease in northern Australia is very high, little is known of the regional epidemiology and molecular characteristics. We conducted a case series of Northern Territory residents reported between 2011 and 2013 with Streptococcus pyogenes isolates from a normally sterile site. Of the 128 reported episodes, the incidence was disproportionately high in the Indigenous population at 69·7/100 000 compared to 8·8/100 000 in the non-Indigenous population. Novel to the Northern Territory is the extremely high incidence in haemodialysis patients of 2205·9/100 000 population; and for whom targeted infection control measures could prevent transmission. The incidences in the tropical north and semi-arid Central Australian regions were similar. Case fatality was 8% (10/128) and streptococcal toxic shock syndrome occurred in 14 (11%) episodes. Molecular typing of 82 isolates identified 28 emm types, of which 63 (77%) were represented by four emm clusters. Typing confirmed transmission between infant twins. While the diverse range of emm types presents a challenge for effective coverage by vaccine formulations, the limited number of emm clusters raises optimism should cluster-specific cross-protection prove efficacious. Further studies are required to determine effectiveness of chemoprophylaxis for contacts and to inform public health response.
UR - http://www.scopus.com/inward/record.url?scp=84941336387&partnerID=8YFLogxK
U2 - 10.1017/S0950268815002010
DO - 10.1017/S0950268815002010
M3 - Article
VL - 144
SP - 1018
EP - 1027
JO - Epidemiology and Infection
JF - Epidemiology and Infection
SN - 0950-2688
IS - 5
ER -