Authors:
Gear RJ, Carter JC, Carapetis JR, Baird R, Davis JS
Authors notes:
Tropical Medicine and International Health. 2014;20(1):40-47
Keywords:
Australia, Bacteraemia, Group A streptococcus, Indigenous, Northern Territory, Tropical
Abstract:
Invasive group A streptococcus (iGAS) disease is an important cause of mortality globally.
The incidence of iGAS in Australia's tropical Northern Territory (NT) has been previously reported as 32.2/100 000 in Indigenous people for the period 1991-1996.
We aimed to measure the incidence and severity of iGAS disease in the NT since this time.
There were 295 confirmed cases of GAS bacteraemia over the study period, with a mean (SD) age of 42.1 (22.0) years, and 163 (55.0%) were male.
The annual age-adjusted incidence was 15.2/100 000 overall and 59.4 in Indigenous Australians.
For 2005-2009, there were 123 cases with the most common focus of infection being skin/soft tissue [44 (35.6%)]; 29 patients (23.6%) required intensive care unit admission and 20 (16.3%) had streptococcal toxic shock syndrome.
Antecedent sore throat or use of non-steroidal anti-inflammatory drugs was rare, but current or recent scabies, pyoderma and trauma were common.
The incidence and severity of iGAS are high and increasing in tropical northern Australia, and urgent attention is needed to improve surveillance and the social determinants of health in this population.
This study adds to emerging data suggesting increasing importance of iGAS in low- and middle-income settings globally.