Epidemiology of Group A Streptococcal bacteraemia in Hunter New England Local Health District, 2008 to 2019

Authors

  • Kirsten M Williamson Hunter New England Population Health, Hunter New England Local Health District, NSW, Australia; National Centre for Epidemiology and Population Health, Australian National University, Acton, ACT, Australia
  • Hemalatha Varadhan NSW Health Pathology, John Hunter Hospital, Newcastle, NSW, Australia
  • Kylie Taylor Hunter New England Population Health, Hunter New England Local Health District, NSW, Australia
  • Kristy Crooks Hunter New England Population Health, Hunter New England Local Health District, NSW, Australia;Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
  • Katie Brett Hunter New England Population Health, Hunter New England Local Health District, NSW, Australia
  • Charlee Law Hunter New England Population Health, Hunter New England Local Health District, NSW, Australia
  • Michelle Butler Hunter New England Population Health, Hunter New England Local Health District, NSW, Australia
  • Trent Butler NSW Health Pathology, John Hunter Hospital, Newcastle, NSW, Australia
  • Emily Green NSW Health Pathology, John Hunter Hospital, Newcastle, NSW, Australia
  • Joshua S Davis Infectious Diseases, John Hunter Hospital, Newcastle, NSW, Australia; School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
  • Paul Wilson Calvary Mater Hospital, Newcastle, NSW, Australia
  • Tambri Housen National Centre for Epidemiology and Population Health, Australian National University, Acton, ACT, Australia; School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
  • Tony Merritt Hunter New England Population Health, Hunter New England Local Health District, NSW, Australia
  • David N Durrheim Hunter New England Population Health, Hunter New England Local Health District, NSW, Australia; School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia

DOI:

https://doi.org/10.33321/cdi.2023.47.49

Keywords:

group A Streptococcus, Streptococcus pyogenes, iGAS, GAS, invasive, bacteraemia, sepsis, notifiable condition, infectious disease, epidemiology

Abstract

Invasive Group A Streptococcal infection (iGAS) is an uncommon but serious infection with Streptococcus pyogenes in a normally sterile body site. Manifestations include bacteraemia, necrotising fasciitis and toxic shock syndrome with attendant serious morbidity and mortality. An increasing incidence of iGAS has been observed in some regions of Australia. iGAS became a nationally notifiable condition from 1 July 2021.

To determine if regional incidence has increased, and to identify priority populations, we undertook a retrospective data analysis of Group A Streptococcal (GAS) bacteraemia cases in Hunter New England Local Health District (HNELHD), New South Wales, Australia, from 1 January 2008 to 31 December 2019, as identified by NSW Health Pathology, John Hunter Hospital.

A total of 486 cases were identified (age-standardised rate: 4.05 cases per 100,000 population per year). Incidence in HNELHD gradually increased over the study period (adjusted incidence rate ratio: 1.04; 95% confidence interval: 1.01–1.07) and was significantly higher in children under 5 years of age; in adults over 70 years of age; in males; and in First Nations peoples. A significant peak occurred in 2017 (9.00 cases per 100,000 population), the cause of which remains unclear.

GAS bacteraemia is uncommon but severe, and incidence in HNELHD has slowly increased. Public health and clinical guidelines must address the needs of priority populations, which include young children, older adults and First Nations peoples. Routine surveillance and genomic analysis will help improve our understanding of iGAS and inform best public health management.

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Published

24/08/23

How to Cite

Williamson, Kirsten M, Hemalatha Varadhan, Kylie Taylor, Kristy Crooks, Katie Brett, Charlee Law, Michelle Butler, et al. 2023. “Epidemiology of Group A Streptococcal Bacteraemia in Hunter New England Local Health District, 2008 to 2019”. Communicable Diseases Intelligence 47 (August). https://doi.org/10.33321/cdi.2023.47.49.

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