Li Jun Thean1, Adam Jenney2, Daniel Engelman3, Lucia Romani4, Handan Wand4, Jyotishna Mani5, Jessica Paka5, Tuliana Cua5, Sera Taole5, Vika Soqo6, Aalisha Sahukhan6, Mike Kama6, Meciusela Tuicakau6, Joseph Kado7, Natalie Carvalho8, Margot Whitfeld9, John Kaldor4, Andrew C Steer3. 1. Tropical Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia. Electronic address: lijun.thean@mcri.edu.au. 2. College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji. 3. Tropical Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia; Melbourne Children's Global Health, Melbourne Children's Campus, The Royal Children's Hospital, Parkville, Victoria, Australia. 4. Kirby Institute, University of New South Wales, Kensington, New South Wales, Australia. 5. Tropical Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia. 6. Ministry of Health and Medical Services, Suva, Fiji. 7. Ministry of Health and Medical Services, Suva, Fiji; Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia. 8. School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia. 9. Department of Dermatology, St. Vincent's Hospital, Darlinghurst, New South Wales, Australia; School of Medicine, University of New South Wales, Kensington, New South Wales, Australia.
Abstract
BACKGROUND: Invasive Staphylococcus aureus (iSA) and group A Streptococcus (iGAS) impose significant health burdens globally. Both bacteria commonly cause skin and soft tissue infections (SSTIs), which can result in invasive disease. Understanding of the incidence of iSA and iGAS remains limited in settings with a high SSTI burden. METHODS: Prospective surveillance for admissions with iSA or iGAS was conducted at the referral hospital in Fiji's Northern Division over 48 weeks between July 2018 and June 2019. RESULTS: There were 55 admissions for iSA and 15 admissions for iGAS (incidence 45.2 and 12.3 per 100,000 person-years, respectively). The highest incidence was found in patients aged ≥65 years (59.6 per 100,000 person-years for iSA and iGAS). The incidence of iSA was higher in indigenous Fijians (iTaukei) (71.1 per 100,000 person-years) compared with other ethnicities (incidence rate ratio 9.7, 95% confidence interval 3.5-36.9). SSTIs were found in the majority of cases of iSA (75%) and iGAS (53.3%). Thirteen of the 14 iGAS strains isolated belonged to emm cluster D (n = 5) or E (n = 8). The case fatality rate was high for both iSA (10.9%) and iGAS (33.3%). CONCLUSIONS: The incidence of iSA and iGAS in Fiji is very high. SSTIs are common clinical foci for both iSA and iGAS. Both iSA and iGAS carry a substantial risk of death. Improved control strategies are needed to reduce the burden of iSA and iGAS in Fiji.
BACKGROUND: Invasive Staphylococcus aureus (iSA) and group A Streptococcus (iGAS) impose significant health burdens globally. Both bacteria commonly cause skin and soft tissue infections (SSTIs), which can result in invasive disease. Understanding of the incidence of iSA and iGAS remains limited in settings with a high SSTI burden. METHODS: Prospective surveillance for admissions with iSA or iGAS was conducted at the referral hospital in Fiji's Northern Division over 48 weeks between July 2018 and June 2019. RESULTS: There were 55 admissions for iSA and 15 admissions for iGAS (incidence 45.2 and 12.3 per 100,000 person-years, respectively). The highest incidence was found in patients aged ≥65 years (59.6 per 100,000 person-years for iSA and iGAS). The incidence of iSA was higher in indigenous Fijians (iTaukei) (71.1 per 100,000 person-years) compared with other ethnicities (incidence rate ratio 9.7, 95% confidence interval 3.5-36.9). SSTIs were found in the majority of cases of iSA (75%) and iGAS (53.3%). Thirteen of the 14 iGAS strains isolated belonged to emm cluster D (n = 5) or E (n = 8). The case fatality rate was high for both iSA (10.9%) and iGAS (33.3%). CONCLUSIONS: The incidence of iSA and iGAS in Fiji is very high. SSTIs are common clinical foci for both iSA and iGAS. Both iSA and iGAS carry a substantial risk of death. Improved control strategies are needed to reduce the burden of iSA and iGAS in Fiji.
Authors: Li Jun Thean; Lucia Romani; Daniel Engelman; Handan Wand; Adam Jenney; Jyotishna Mani; Jessica Paka; Tuliana Cua; Sera Taole; Maciu Silai; Komal Ashwini; Aalisha Sahukhan; Mike Kama; Meciusela Tuicakau; Joseph Kado; Matthew Parnaby; Natalie Carvalho; Margot Whitfeld; John Kaldor; Andrew C Steer Journal: Lancet Reg Health West Pac Date: 2022-03-22
Authors: Kate M Miller; Jonathan R Carapetis; Thomas Cherian; Roderick Hay; Michael Marks; Janessa Pickering; Jeffrey W Cannon; Theresa Lamagni; Lucia Romani; Hannah C Moore; Chris A Van Beneden; Dylan D Barth; Asha C Bowen Journal: Open Forum Infect Dis Date: 2022-09-15 Impact factor: 4.423
Authors: Susanna J Lake; John M Kaldor; Myra Hardy; Daniel Engelman; Andrew C Steer; Lucia Romani Journal: Clin Infect Dis Date: 2022-09-29 Impact factor: 20.999