Health Protection Surveillance Centre, Dublin, Ireland.
Euro Surveill. 2011 Oct 13;16(41):19988.
Invasive group A streptococcal infections (iGAS) are a major clinical and public health challenge. iGAS is a notifiable disease in Ireland since 2004. The aim of this paper is to describe the epidemiology of iGAS in Ireland for the first time over the seven-year period from 2004 to 2010. The Irish national electronic infectious disease reporting system was used by laboratories to enter the source of iGAS isolates, and by departments of public health to enter clinical and epidemiological details. We extracted and analysed data from 1 January 2004 to 31 December 2010. Over the study period, 400 iGAS cases were notified. The annual incidence of iGAS doubled, from 0.8 per 100,000 population in 2004 to 1.6 in 2008, and then remained the same in 2009 and 2010. The reported average annual incidence rates were highest among children up to five years of age (2.3/100,000) and adults aged over 60 years (3.2/100,000). The most common risk factors associated with iGAS were skin lesions or wounds. Of the 174 people for whom clinical syndrome information was available, 28 (16%) cases presented with streptococcal toxic shock syndrome and 19 (11%) with necrotising fasciitis. Of the 141 cases for whom seven-day outcomes were recorded, 11 people died with iGAS identified as the main cause of death (seven-day case fatality rate 8%). The notification rate of iGAS in Ireland was lower than that reported in the United Kingdom, Nordic countries and North America but higher than southern and eastern European countries. The reasons for lower notification rates in Ireland compared with other countries may be due to a real difference in incidence, possibly due to prescribing practices, or due to artefacts resulting from the specific Irish case definition and/or low reporting in the early stages of a new surveillance system. iGAS disease remains an uncommon but potentially severe disease in Ireland. Ongoing surveillance is required in order to undertake appropriate control measures and gain a greater understanding of this disease.
侵袭性 A 组链球菌感染（iGAS）是一个主要的临床和公共卫生挑战。自 2004 年以来，iGAS 在爱尔兰是一种须报告的疾病。本文的目的是首次描述 2004 年至 2010 年七年期间爱尔兰 iGAS 的流行病学情况。实验室使用爱尔兰国家电子传染病报告系统输入 iGAS 分离株的来源，公共卫生部门则输入临床和流行病学细节。我们从 2004 年 1 月 1 日至 2010 年 12 月 31 日提取并分析了数据。在研究期间，共报告了 400 例 iGAS 病例。iGAS 的年发病率增加了一倍，从 2004 年的每 10 万人 0.8 例增加到 2008 年的每 10 万人 1.6 例，2009 年和 2010 年保持不变。报告的年平均发病率在 0-5 岁儿童中最高（每 10 万人 2.3 例），60 岁以上成人中次之（每 10 万人 3.2 例）。与 iGAS 相关的最常见危险因素是皮肤损伤或伤口。在提供临床综合征信息的 174 人中，28 例（16%）患者表现为链球菌中毒性休克综合征，19 例（11%）患者为坏死性筋膜炎。在 141 例记录了 7 天结局的病例中，有 11 人死于 iGAS，这是主要死因（7 天病死率 8%）。爱尔兰的 iGAS 报告率低于英国、北欧国家和北美的报告率，但高于南欧和东欧国家。与其他国家相比，爱尔兰报告率较低的原因可能是由于发病率的实际差异，这可能是由于处方实践的原因，也可能是由于特定的爱尔兰病例定义和/或新监测系统早期报告率低导致的人为因素。在爱尔兰，iGAS 疾病仍然是一种罕见但潜在严重的疾病。需要进行持续监测，以便采取适当的控制措施，并更好地了解这种疾病。
