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Bloodstream infection due to β-hemolytic streptococci: a population-based comparative analysis

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Abstract

Purpose

Although the burden of illness due to Streptococcus pyogenes is widely recognized, other β-hemolytic streptococci are also important causes of invasive infections. The objective of this study was to compare the population-based epidemiology of groups A, B, and C/G β-hemolytic streptococcal bloodstream infection (BSI).

Methods

Population-based surveillance was conducted in the western interior of British Columbia, Canada, 2011–2018.

Results

A total of 210 episodes were identified for an incidence of 14.4 per 100,000; the incidences of groups A, B and C/G streptococcal BSI were 4.2, 4.7, and 5.5 per 100,000, respectively. There was an increasing annual incidence of β-hemolytic streptococcal BSI from 2011 through to a peak incidence in 2016 that decreased thereafter. Fifty-two percent (110) of BSIs were community associated, 43% (91) were healthcare associated, and 4% (9) were hospital onset. Patients with group A were younger, more likely to be female, and have fewer co-morbidities than patients with groups B and C/G streptococcal BSI. The most common focus of infection was soft tissue (109/52%), followed by primary (33; 16%), and bone and joint (20; 10%) and these varied by streptococcal species (p < 0.001). The 30-day all-cause case fatality rate was 11% (24/210) and did not significantly vary by group (p = 0.7).

Conclusion

Although the determinants vary, the overall burden of disease related to BSI is similar amongst groups A, B and C/G β-hemolytic streptococci.

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Authors and Affiliations

  1. Department of Intensive Care Services, Royal Brisbane and Women’s Hospital, Level 3 Ned Hanlon Building, Butterfield Street, Herston, QLD, 4029, Australia

    Kevin B. Laupland

  2. Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia

    Kevin B. Laupland

  3. Department of Medicine, Royal Inland Hospital, Kamloops, BC, Canada

    Kevin B. Laupland & Elizabeth C. Parfitt

  4. Department of Pathology and Laboratory Medicine, Royal Inland Hospital, Kamloops, BC, Canada

    Kelsey Pasquill & Lisa Steele

Authors
  1. Kevin B. Laupland
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  2. Kelsey Pasquill
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  4. Lisa Steele
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Correspondence to Kevin B. Laupland.

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Laupland, K.B., Pasquill, K., Parfitt, E.C. et al. Bloodstream infection due to β-hemolytic streptococci: a population-based comparative analysis. Infection 47, 1021–1025 (2019). https://doi.org/10.1007/s15010-019-01356-9

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  • DOI: https://doi.org/10.1007/s15010-019-01356-9

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