Oliver Jane, Wilmot Mathilda, Strachan Janet, St George Siobhan, Lane Courtney R, Ballard Susan A, Sait Michelle, Gibney Katherine, Howden Benjamin P, Williamson Deborah A
Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth St, Melbourne, Victoria, Australia, 3000 - Murdoch Children’s Research Institute, Royal Children’s Hospital, 50 Flemington Rd, Parkville, Victoria, Australia, 3052
Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth St, Melbourne, Victoria, Australia, 3000
Commun Dis Intell (2018). 2019 Mar 15;43. doi: 10.33321/cdi.2019.43.8.
Invasive Group A Streptococcus (iGAS) disease can cause permanent disability and death. The incidence of iGAS has increased in many developed countries since the 1980s. iGAS disease is not nationally notifiable in Australia or at the state level in Victoria. The Victorian Hospital Pathogen Surveillance Scheme (VHPSS) is a voluntary laboratory-based surveillance system established in 1988. We assessed the trends and molecular epidemiology of iGAS disease in Victoria from 2007-2017.
A case of iGAS was defined as an individual for whom Group A Streptococcus (GAS) was isolated from a normally sterile body site. Data on all iGAS cases, as reported to the VHPSS, between 1 January 2007 and 31 December 2017 were examined.
A total of 1,311 iGAS cases had associated isolates, and M Protein Gene (emm) typing was performed for 91.6%. The mean annual incidence was 2.1 (95% CI: 1.8-2.5) per 100,000 population per year, increasing 2.7-fold over the study period. In total, 140 different iGAS emm-types were observed, with the ten most prevalent types comprising 63.1% of the sample.
Despite limitations in this surveillance data, we observed increasing rates of iGAS disease in Victoria. iGAS incidence exceeded the mean annual incidence for invasive meningococcal disease, calculated using Victorian data from the National Notifiable Diseases Surveillance System (2.1 vs. 0.6 cases per 100,000 population per year, respectively). Mandatory case notification could enhance disease control and prevention. Further, the diversity in emm-types emphasises the importance of effective secondary chemoprophylaxis in prevention, alongside GAS vaccine development.
侵袭性A群链球菌（iGAS）疾病可导致永久性残疾和死亡。自20世纪80年代以来，许多发达国家的iGAS发病率有所上升。在澳大利亚或维多利亚州，iGAS疾病并非全国法定报告疾病。维多利亚州医院病原体监测计划（VHPSS）是1988年建立的一个基于实验室的自愿监测系统。我们评估了2007年至2017年维多利亚州iGAS疾病的趋势和分子流行病学情况。
iGAS病例定义为从通常无菌的身体部位分离出A群链球菌（GAS）的个体。对2007年1月1日至2017年12月31日期间向VHPSS报告的所有iGAS病例的数据进行了检查。
共有1311例iGAS病例有相关分离株，其中91.6%进行了M蛋白基因（emm）分型。年平均发病率为每10万人每年2.1例（95%置信区间：1.8 - 2.5），在研究期间增加了2.7倍。总共观察到140种不同的iGAS emm型，其中最常见的十种类型占样本的63.1%。
尽管该监测数据存在局限性，但我们观察到维多利亚州iGAS疾病发病率在上升。iGAS发病率超过了使用国家法定报告疾病监测系统中维多利亚州数据计算的侵袭性脑膜炎球菌疾病的年平均发病率（分别为每10万人每年2.1例和0.6例）。强制病例报告可加强疾病控制和预防。此外，emm型的多样性强调了在预防中进行有效二级化学预防以及开发GAS疫苗的重要性。
