• George E Nelson, Tracy Pondo, Karrie-Ann Toews, Monica M Farley, Mary Lou Lindegren, Ruth Lynfield, Deborah Aragon, Shelley M Zansky, James P Watt, Paul R Cieslak, Kathy Angeles, Lee H Harrison, Susan Petit, Bernard Beall, and Chris A Van Beneden.
• Epidemic Intelligence Service National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention Vanderbilt University, Nashville, Tennessee.
• Clin. Infect. Dis. 2016 Aug 15; 63 (4): 478-86.

BackgroundInvasive 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.MethodsFrom 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.ResultsWe 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.ConclusionsThe burden of invasive GAS infection in the United States remains substantial. Vaccines under development could have a considerable public health impact.© The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

37 keywords...

hide…