Golden Alyssa R, Griffith Averil, Tyrrell Gregory J, Kus Julianne V, McGeer Allison, Domingo Marc-Christian, Hoang Linda, Minion Jessica, Van Caeseele Paul, Smadi Hanan, Haldane David, Yu Yang, Ding Xiaofeng, Steven Laura, McFadzen Jan, Primeau Courtney, Franklin Kristyn, Martin Irene
National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB.
Provincial Laboratory for Public Health, Edmonton, AB.
Can Commun Dis Rep. 2024 May 24;50(5):135-143. doi: 10.14745/ccdr.v50i05a03.
Invasive group A streptococcal (iGAS, ) disease has been a nationally notifiable disease in Canada since 2000. This report summarizes the demographics, types, and antimicrobial resistance of iGAS isolates collected in Canada in 2021 and 2022.
The Public Health Agency of Canada's National Microbiology Laboratory collaborates with provincial and territorial public health laboratories to conduct national surveillance of invasive . typing was performed using the Centers for Disease Control and Prevention sequencing protocol or extracted from whole-genome sequencing data. Antimicrobial susceptibilities were determined using Kirby-Bauer disk diffusion according to Clinical and Laboratory Standards Institute guidelines or predicted from whole-genome sequencing data based on the presence of resistance determinants.
Overall, the incidence of iGAS disease in Canada was 5.56 cases per 100,000 population in 2021, decreasing from the peak of 8.6 cases per 100,000 population in 2018. A total of 2,630 iGAS isolates were collected during 2022, representing an increase from 2021 (n=2,179). In particular, there was a large increase in isolates collected from October to December 2022. The most predominant type overall in 2021 and 2022 was 49, at 21.5% (n=468) and 16.9% (n=444), respectively, representing a significant increase in prevalence since 2018 (<0.0001). The former most prevalent type, 1, increased from 0.5% (n=10) in 2021 to 4.8% (n=125) in 2022; similarly, 12 increased from 1.0% (n=22) in 2021 to 5.8% (n=151) in 2022. These two types together accounted for almost 25% of isolates collected in late 2022 (October to December). Antimicrobial resistance rates in 2021 and 2022 included: 14.9%/14.1% erythromycin resistance, 4.8%/3.0% clindamycin resistance, and <1% chloramphenicol resistance.
The increase of iGAS isolates collected in Canada is an important public health concern. Continued surveillance of iGAS is critical to monitor expanding types and antimicrobial resistance patterns.
自2000年以来，侵袭性A组链球菌（iGAS）疾病在加拿大一直属于法定需报告的疾病。本报告总结了2021年和2022年在加拿大收集的iGAS分离株的人口统计学特征、类型及抗菌药物耐药情况。
加拿大公共卫生署国家微生物实验室与省级和地区公共卫生实验室合作，对侵袭性[疾病名称未完整给出]进行全国监测。分型采用美国疾病控制与预防中心的测序方案进行，或从全基因组测序数据中提取。根据临床和实验室标准协会指南，采用 Kirby-Bauer 纸片扩散法测定抗菌药物敏感性，或根据耐药决定因素的存在情况从全基因组测序数据中预测。
总体而言，2021年加拿大iGAS疾病的发病率为每10万人5.56例，较2018年每10万人8.6例的峰值有所下降。2022年共收集到2630株iGAS分离株，较2021年（n = 2179）有所增加。特别是，2022年10月至12月收集的分离株大幅增加。2021年和2022年总体上最主要的[疾病名称未完整给出]类型为49型，分别占21.5%（n = 468）和16.9%（n = 444），自2018年以来患病率显著上升（<0.0001）。此前最常见的1型，从2021年的0.5%（n = 10）增至2022年的4.8%（n = 125）；同样，12型从2021年的1.0%（n = 22）增至2022年的5.8%（n = 151）。这两种类型在2022年末（10月至12月）收集的分离株中合计占近25%。2021年和2022年的抗菌药物耐药率包括：红霉素耐药率为14.9%/14.1%，克林霉素耐药率为4.8%/3.0%，氯霉素耐药率<1%。
加拿大收集的iGAS分离株数量增加是一个重要的公共卫生问题。持续监测iGAS对于监测不断扩大的[疾病名称未完整给出]类型和抗菌药物耐药模式至关重要。
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