Invasive group A streptococcal disease surveillance in Canada, 2020

Golden, Alyssa; Griffith, Averil; Demczuk, Walter; Tyrrell, Gregory J.; Kus, Julianne V.; McGeer, Allison; Domingo, Marc-Christian; Hoang, Linda; Minion, Jessica; Caeseele, Paul Van; Smadi, Hanan; Haldane, David; Zahariadis, George; Mead, Kristen; Steven, Laura; Strudwick, Lori; Li, Anita; Mulvey, Michael R.; Martín, Irene

doi:10.14745/ccdr.v48i09a05

Cited by 4 publications

(9 citation statements)

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“…Provincially, in British Columbia, rates of iGAS have been higher than expected since 2017, with the incidence in the last six years remaining stable (( 8 )). Globally, an increase in the incidence of iGAS over time has also been observed in many countries, including Canada (( 9 – 12 )). Previous analyses have hypothesized that the observed increase is linked to both the increase in genetic diversity of circulating emm types and compounding societal risk factors, such as homelessness and substance use (( 10 , 13 – 17 )).…”

Section: Discussionmentioning

confidence: 97%

“…Nationally, emm 1 has been the dominant emm type for the last decade (( 21 )). Since 2014, the prevalence of emm 1 has been decreasing nationally and was surpassed by emm 76 in 2019 and emm 49 in 2020 (( 9 , 22 – 24 )). To date in the available literature, emm types 49, 83, and 92 have not been associated with more life-threatening illness.…”

Section: Discussionmentioning

confidence: 99%

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Invasive group A streptococcal (iGAS) surveillance in Island Health, British Columbia, 2022

Nwosu,

Schut,

Arlotti Wood

et al. 2023

CCDR

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Background Invasive group A streptococcal disease (iGAS) is caused by Streptococcus pyogenes group A bacteria. In 2022, multiple disease alerts for iGAS in the Island Health region, in the context of increased infections in the paediatric population in Europe and the United States, prompted further investigation into local trends. This surveillance study summarizes epidemiological trends of iGAS in the region covered by Island Health, a regional health authority in British Columbia, in 2022. Methods In British Columbia, iGAS is a reportable disease; all confirmed cases are reported to the regional authority and the provincial health authority (BC Centre for Disease Control). Island Health’s iGAS surveillance system is passive and collects information on cases that are identified through laboratory testing. Surveillance data were summarized for 2022 and compared with historical data from 2017–2021. Results In 2022, the incidence rate was 11.4 cases per 100,000 population (n=101), the highest observed rate in the last six years. The median age of cases was 53 years, with a range of 0–96 years, and 64% of cases were male. The highest risk of infection was reported in men 40–59 years of age, with an incidence rate of 21.3 cases per 100,000 population. The most common emm types were emm 92 (n=14), emm 49 (n=13), and emm 83 (n=12). Overall, 85% (n=86) of cases were hospitalized, 21% (n=21) were admitted to the intensive care unit, and 6% (n=6) died. Conclusion This study highlights that the incidence of iGAS in the Island Health region continued to increase throughout the coronavirus disease 2019 (COVID-19) pandemic, reaching its highest annual rate in 2022. In contrast to reports from Europe and the United States, there was no notable increase in infections in the paediatric population. Given the sustained increase in iGAS activity, continued monitoring and description of the epidemiology of these cases on a regular basis is imperative.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Invasive group A streptococcal (iGAS) surveillance in Island Health, British Columbia, 2022

Nwosu,

Schut,

Arlotti Wood

et al. 2023

CCDR

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“…Invasive group A Streptococcus (iGAS, Streptococcus pyogenes ) is responsible for a wide range of human diseases, the most serious of which include bacteraemia, streptococcal toxic shock syndrome, necrotizing fasciitis, and endocarditis (( 1 )). In Canada, the overall incidence of iGAS infections has steadily increased since becoming a notifiable disease in 2000, peaking at a rate of 8.61 cases per 100,000 population in 2018 (( 2 )). In 2020, Canada reported decreased submissions of iGAS isolates, attributed to the containment measures put in place to control the SARS-CoV-2 pandemic (COVID-19) (( 2 )).…”

Section: Introductionmentioning

confidence: 99%

“…In Canada, the overall incidence of iGAS infections has steadily increased since becoming a notifiable disease in 2000, peaking at a rate of 8.61 cases per 100,000 population in 2018 (( 2 )). In 2020, Canada reported decreased submissions of iGAS isolates, attributed to the containment measures put in place to control the SARS-CoV-2 pandemic (COVID-19) (( 2 )). There was also a significant shift in the emm types most commonly associated with disease in Canada, shifting from the formerly prevalent emm 1 toward emm 49 and emm 76 (( 2 )).…”

Section: Introductionmentioning

confidence: 99%

“…In 2020, Canada reported decreased submissions of iGAS isolates, attributed to the containment measures put in place to control the SARS-CoV-2 pandemic (COVID-19) (( 2 )). There was also a significant shift in the emm types most commonly associated with disease in Canada, shifting from the formerly prevalent emm 1 toward emm 49 and emm 76 (( 2 )).…”

Section: Introductionmentioning

confidence: 99%

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Invasive group A streptococcal disease surveillance in Canada, 2021–2022

Golden,

Griffith,

Tyrell

et al. 2024

CCDR

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Background Invasive group A streptococcal (iGAS, Streptococcus pyogenes ) disease has been a nationally notifiable disease in Canada since 2000. This report summarizes the demographics, emm types, and antimicrobial resistance of iGAS isolates collected in Canada in 2021 and 2022. Methods The Public Health Agency of Canada’s National Microbiology Laboratory collaborates with provincial and territorial public health laboratories to conduct national surveillance of invasive S. pyogenes . Emm typing was performed using the Centers for Disease Control and Prevention emm 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. Results 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 emm type overall in 2021 and 2022 was emm 49, at 21.5% (n=468) and 16.9% (n=444), respectively, representing a significant increase in prevalence since 2018 ( p <0.0001). The former most prevalent type, emm 1, increased from 0.5% (n=10) in 2021 to 4.8% (n=125) in 2022; similarly, emm 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. Conclusion The increase of iGAS isolates collected in Canada is an important public health concern. Continued surveillance of iGAS is critical to monitor expanding emm types and antimicrobial resistance patterns.

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Streptococcal Toxic Shock Syndrome: A Case Series Emphasizing the Urgency of Recognition and Tailored Treatment

Yavari,

Puri

2024

The Journal of Emergency Medicine

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Invasive group A streptococcal disease surveillance in Canada, 2020

Cited by 4 publications

References 0 publications

Invasive group A streptococcal (iGAS) surveillance in Island Health, British Columbia, 2022

Invasive group A streptococcal (iGAS) surveillance in Island Health, British Columbia, 2022

Invasive group A streptococcal disease surveillance in Canada, 2021–2022

Streptococcal Toxic Shock Syndrome: A Case Series Emphasizing the Urgency of Recognition and Tailored Treatment

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