Kevin B Laupland1,2,3, Kelsey Pasquill4, Elizabeth C Parfitt5, Lisa Steele4. 1. Department of Intensive Care Services, Royal Brisbane and Women's Hospital, Level 3 Ned Hanlon Building, Butterfield Street, Herston, QLD, 4029, Australia. Kevin.laupland@qut.edu.au. 2. Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia. Kevin.laupland@qut.edu.au. 3. Department of Medicine, Royal Inland Hospital, Kamloops, BC, Canada. Kevin.laupland@qut.edu.au. 4. Department of Pathology and Laboratory Medicine, Royal Inland Hospital, Kamloops, BC, Canada. 5. Department of Medicine, Royal Inland Hospital, Kamloops, BC, Canada.
Abstract
PURPOSE: Although the burden of illness due to Streptococcus pyogenes is widely recognized, other β-hemolytic streptococci are also important causes of invasive infections. The objective of this study was to compare the population-based epidemiology of groups A, B, and C/G β-hemolytic streptococcal bloodstream infection (BSI). METHODS: Population-based surveillance was conducted in the western interior of British Columbia, Canada, 2011-2018. RESULTS: A total of 210 episodes were identified for an incidence of 14.4 per 100,000; the incidences of groups A, B and C/G streptococcal BSI were 4.2, 4.7, and 5.5 per 100,000, respectively. There was an increasing annual incidence of β-hemolytic streptococcal BSI from 2011 through to a peak incidence in 2016 that decreased thereafter. Fifty-two percent (110) of BSIs were community associated, 43% (91) were healthcare associated, and 4% (9) were hospital onset. Patients with group A were younger, more likely to be female, and have fewer co-morbidities than patients with groups B and C/G streptococcal BSI. The most common focus of infection was soft tissue (109/52%), followed by primary (33; 16%), and bone and joint (20; 10%) and these varied by streptococcal species (p < 0.001). The 30-day all-cause case fatality rate was 11% (24/210) and did not significantly vary by group (p = 0.7). CONCLUSION: Although the determinants vary, the overall burden of disease related to BSI is similar amongst groups A, B and C/G β-hemolytic streptococci.
PURPOSE: Although the burden of illness due to Streptococcus pyogenes is widely recognized, other β-hemolytic streptococci are also important causes of invasive infections. The objective of this study was to compare the population-based epidemiology of groups A, B, and C/G β-hemolytic streptococcal bloodstream infection (BSI). METHODS: Population-based surveillance was conducted in the western interior of British Columbia, Canada, 2011-2018. RESULTS: A total of 210 episodes were identified for an incidence of 14.4 per 100,000; the incidences of groups A, B and C/G streptococcal BSI were 4.2, 4.7, and 5.5 per 100,000, respectively. There was an increasing annual incidence of β-hemolytic streptococcal BSI from 2011 through to a peak incidence in 2016 that decreased thereafter. Fifty-two percent (110) of BSIs were community associated, 43% (91) were healthcare associated, and 4% (9) were hospital onset. Patients with group A were younger, more likely to be female, and have fewer co-morbidities than patients with groups B and C/G streptococcal BSI. The most common focus of infection was soft tissue (109/52%), followed by primary (33; 16%), and bone and joint (20; 10%) and these varied by streptococcal species (p < 0.001). The 30-day all-cause case fatality rate was 11% (24/210) and did not significantly vary by group (p = 0.7). CONCLUSION: Although the determinants vary, the overall burden of disease related to BSI is similar amongst groups A, B and C/G β-hemolytic streptococci.
Authors: Melissa C MacKinnon; Scott A McEwen; David L Pearl; Outi Lyytikäinen; Gunnar Jacobsson; Peter Collignon; Daniel B Gregson; Louis Valiquette; Kevin B Laupland Journal: BMC Infect Dis Date: 2021-06-25 Impact factor: 3.090