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Published on: August 19, 2016
Severe Streptococcus pyogenes infections, United Kingdom, 2003-2004
Theresa L Lamagni1, Shona Neal, Catherine Keshishian
1Health Protection Agency, London, United Kingdom. theresa.lamagni@hpa.org.uk
Severe Streptococcus pyogenes infections are more common than previously thought, with skin infections most frequent. Early death is a risk, highlighting the need for targeted interventions against this bacterial pathogen.
Area of Science:
- Epidemiology
- Infectious Diseases
- Public Health
Background:
- Streptococcus pyogenes (group A Streptococcus) can cause severe invasive disease.
- Europe-wide surveillance initiatives aim to understand current epidemiologic patterns.
- Previous estimates of severe S. pyogenes infection incidence may be underestimates.
Purpose of the Study:
- To conduct enhanced population-based surveillance for severe S. pyogenes infections in the United Kingdom.
- To determine the incidence, clinical manifestations, and risk factors for severe S. pyogenes disease.
- To identify predictors of poor patient outcomes, including mortality and streptococcal toxic shock syndrome.
Main Methods:
- Enhanced, population-based surveillance for severe S. pyogenes infections in the UK from 2003-2004.
- Case ascertainment and data collection on demographics, clinical presentation, risk factors, and outcomes.
- Statistical analysis to determine incidence, common manifestations, risk factors, and mortality rates.
Main Results:
- 3,775 confirmed cases of severe S. pyogenes infection identified over 2 years (incidence 3.33/100,000 population).
- Skin/soft tissue infections (42%) and respiratory tract infections (17%) were most common.
- Injection drug use was a risk factor in 20% of cases; 1 in 5 patients died within 7 days.
- Necrotizing fasciitis had a high mortality rate (34%).
- NSAIDs, alcoholism, young age, and emm/M3 types were associated with increased risk for streptococcal toxic shock syndrome.
Conclusions:
- Severe S. pyogenes infections pose a significant public health burden in the UK, with higher incidence than previously estimated.
- Understanding disease patterns and risk factors is crucial for developing effective interventions.
- Identifying predictors of poor outcomes, such as rapid mortality and toxic shock syndrome, can guide clinical management and public health strategies.
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