Severe Streptococcus pyogenes Infections, United Kingdom, 2003–2004
2008

Severe Streptococcus pyogenes Infections in the UK (2003-2004)

Sample size: 3775 publication 10 minutes Evidence: high

Author Information

Author(s): Lamagni Theresa L., Neal Shona, Keshishian Catherine, Alhaddad Neelam, George Robert, Duckworth Georgia, Vuopio-Varkila Jaana, Efstratiou Androulla

Primary Institution: Health Protection Agency, London, United Kingdom

Hypothesis

The epidemiology of severe disease caused by Streptococcus pyogenes has changed, with increased incidence and different risk groups.

Conclusion

The study identified 3,775 confirmed cases of severe S. pyogenes infection, revealing a higher incidence than previously estimated and highlighting significant risk factors and mortality rates.

Supporting Evidence

  • 3,775 confirmed cases of severe S. pyogenes infection were identified over 2 years.
  • Skin/soft tissue infections were the most common manifestation (42%).
  • One in 5 infected case-patients died within 7 days of diagnosis.
  • The highest mortality rate was for cases of necrotizing fasciitis (34%).
  • Injection drug use was identified as a risk factor for 20% of case-patients.
  • Nonsteroidal antiinflammatory drugs were associated with increased risk for streptococcal toxic shock syndrome.

Takeaway

This study found that many people got very sick from a type of bacteria called Streptococcus pyogenes, and some even died from it. It helps doctors understand who is most at risk.

Methodology

Enhanced population-based surveillance was conducted to identify cases of severe S. pyogenes disease from January 1, 2003, to December 31, 2004.

Potential Biases

Potential bias in questionnaire completion favoring more severe cases.

Limitations

The study may have missed additional diagnosed cases due to reliance on local reporting.

Participant Demographics

The majority of case-patients were white (95%), with a higher incidence in males and among the elderly and very young.

Statistical Information

P-Value

0.012

Confidence Interval

95% CI 1.12–1.55

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.3201/eid1402.070888

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