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Trends in beta-hemolytic Streptococcus infections within Veterans' Affairs medical centers from 2009 to 2018
GiGi Yam1, Bethany A Wattengel1, Michael T Carter1
1Department of Pharmacy, Western NY VA Healthcare System, Buffalo, New York.
Insights
This study analyzed trends in beta-hemolytic Streptococcus cultures among Veterans, revealing significant associations between invasive strains and mortality. The findings underscore the serious health impact of these infections.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Public Health Surveillance
Background:
- Beta-hemolytic Streptococcus (GBS) infections pose a significant public health concern.
- Understanding trends in GBS infections is crucial for effective management and prevention strategies.
Purpose of the Study:
- To describe recent trends in invasive and noninvasive beta-hemolytic Streptococcus cultures within the Veterans' Affairs (VA) cohort.
- To analyze the association between GBS infection types and patient mortality.
Main Methods:
- Retrospective cohort study analyzing data from January 1, 2009, to January 1, 2019.
- Inclusion of all patients aged 18 years and older with positive beta-hemolytic Streptococcus cultures at VA facilities.
- Data retrieval from the VA Corporate Data Warehouse using SQL.
Main Results:
- Over 40,000 patients had positive GBS cultures; median age was 64, median Charlson comorbidity index was 4.
- The 30-day all-cause mortality rate for invasive GBS was 2.3%, and 90-day mortality was 4.4%.
- Mortality rates were higher for Streptococcus group A and groups C/G combined compared to group B.
Conclusions:
- Trends in invasive and noninvasive beta-hemolytic Streptococcus cultures indicate a link to disease and mortality.
- The public health burden of beta-hemolytic Streptococcus infections necessitates continued attention and research.
- These findings highlight the importance of not underestimating the impact of GBS infections in patient populations.
Objective:
The purpose of this study was to describe the recent trends of invasive and noninvasive β-hemolytic Streptococcus cultures in the Veterans' Affairs (VA) cohort from 2009 to 2018.
Design:
Retrospective cohort study from January 1, 2009, to January 1, 2019.
Setting:
Veterans' Affairs medical centers.
Patients Or Participants:
All patients aged 18 years and older with cultures positive for β-hemolytic Streptococcus at a VA facility were included in the study.
Intervention(S):
Data were retrieved from the VA Corporate Data Warehouse using structure query language through the SQL Server Management Studio software.
Results:
Between 2009 and 2018, there were 40,625 patients with cultures with β-hemolytic Streptococcus. The median age was 64 years (interquartile range [IQR], 55-71) and the median Charlson comorbidity index was 4 (IQR, 2-7). Distributions for each type of β-hemolytic Streptococcus based on site of culture are provided. The 30-day all-cause mortality rate from all invasive β-hemolytic Streptococcus cases was 2.3%, and the 90-day all-cause mortality rate was 4.4%. The 30- and 90-day all-cause mortality rates for Streptococcus cases were higher for group A (3.9% and 6.1% respectively) and for groups C and G combined (3.2% and 6.1%, respectively) than for group B (2.0% and 4.0%, respectively).
Conclusions:
Trends of cultures for invasive and noninvasive β-hemolytic Streptococcus suggest an association with disease and mortality. The burden associated with β-hemolytic Streptococcus infections should not be underestimated.