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アメリカ合衆国10州における侵入性A群ストレプトコック感染症
Christopher J Gregory1, Jennifer Onukwube Okaro1, Arthur Reingold2,3
1Division of Bacterial Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia.
JAMA
|April 7, 2025
まとめ
2013年から2022年にかけて,侵入性グループAストレプトコッカス (GAS) 感染症は米国10州で著しく増加しました. 公共衛生の取り組みは 加速し,特にリスクの高い集団で GASを制御する必要があります.
科学分野:
- 感染症
- 流行病学
- 公衆衛生の監視
背景:
- 侵襲的なA群ストレプトコッカス (GAS) 感染症は,かなりの罹病率,死亡率,および経済的負担を伴う,重大な公衆衛生上の脅威である.
- 侵襲的なGAS疾患の現在の傾向を理解することは,効果的な公衆衛生の介入に不可欠です.
研究 の 目的:
- 米国10州における侵入性GAS疾患の発生率を更新する.
- 2013年から2022年の傾向を分析し,人口統計とリスク因子の関連を特定する.
主な方法:
- アクティブ・バクテリア・コア・サーベイランス・ネットワーク (3490万人) の集団ベースの監視データを分析した.
- 症例は,不妊部位からのGAS分離または特定の臨床症候群 (2013年−2022年) によって定義された.
- 全ゲノム配列決定は2015年以降,単離体特徴と抗菌感受性試験に使用された.
主要な成果:
- 侵襲的なガスの発生率は100,000人に3. 6から8. 2に増加した (2013-2022年).
- 最も高い発症率は65歳以上で,最も高い相対的な増加率は18歳から64歳の成人でした.
- アメリカン・インディアン/アラスカ先住民,ホームレス,注射薬物使用者,長期介護施設の住人の間で発生率が高いことが確認された. マクロライドとクリンダミシンに対する抗菌剤耐性が著しく増加した.
結論:
- 侵襲的なGAS感染は2013年から2022年の間に米国で顕著に増加しました.
- 侵襲的なガスの影響を受ける人口に焦点を当てた 標的型予防と制御戦略は緊急に必要である.
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