Invasive Group A Streptococcal Disease in District 2: Detect, Investigate, and Collaborate!
Abstract
Background
Group A Streptococcus (GAS) is a type of bacteria that can cause life-threatening “invasive” (IGAS) infections upon entering body sites that do not normally have bacteria in them. Late 2022, case investigations revealed an increase in reported IGAS within District 2 compared to previous years, with the number of cases peaking in April 2023.
Methods
Reported cases were pulled from 11/01/2022 to 07/31/2023 from the State Electronic Notifiable Disease Surveillance System. Data was entered in Excel and sorted by onset date, hospital admission, and residential county. Descriptive analysis was performed in R for confirmation status, mortality, patient demographics, hospital stay duration, facility-related information, treatment, and seasonality. Logistic regression models were built for the outcomes of survival and disease severity using age, race, ethnicity, and days of admission (in addition to city and onset month for severity) as predictors.
Results
54% of IGAS cases were reported from local healthcare facilities, with the populations most impacted being the elderly and young children. Black or African American and Hispanic populations were disproportionately impacted with incidence rates of 13 and 11.8 cases, respectively, per 100,000. Logistic regression indicated (1) longer hospital stays were associated with higher survival likelihood (OR: 1.27; p < 0.05), and (2) IGAS was found more severe in certain months such as March (OR: 29.5; p = 0.21) and May (OR: 475; p < 0.05).
Conclusion
Analyses confirmed unequal impact of IGAS on certain populations and revealed longer admission and seasonality play significant roles in illness severity. Early detection, investigation, and collaboration with healthcare systems and other stakeholders are key components to reducing IGAS cases.
Keywords
Invasive Group A Strep, IGAS, descriptive analysis, logistic regression, incidence, population
Invasive Group A Streptococcal Disease in District 2: Detect, Investigate, and Collaborate!
Background
Group A Streptococcus (GAS) is a type of bacteria that can cause life-threatening “invasive” (IGAS) infections upon entering body sites that do not normally have bacteria in them. Late 2022, case investigations revealed an increase in reported IGAS within District 2 compared to previous years, with the number of cases peaking in April 2023.
Methods
Reported cases were pulled from 11/01/2022 to 07/31/2023 from the State Electronic Notifiable Disease Surveillance System. Data was entered in Excel and sorted by onset date, hospital admission, and residential county. Descriptive analysis was performed in R for confirmation status, mortality, patient demographics, hospital stay duration, facility-related information, treatment, and seasonality. Logistic regression models were built for the outcomes of survival and disease severity using age, race, ethnicity, and days of admission (in addition to city and onset month for severity) as predictors.
Results
54% of IGAS cases were reported from local healthcare facilities, with the populations most impacted being the elderly and young children. Black or African American and Hispanic populations were disproportionately impacted with incidence rates of 13 and 11.8 cases, respectively, per 100,000. Logistic regression indicated (1) longer hospital stays were associated with higher survival likelihood (OR: 1.27; p < 0.05), and (2) IGAS was found more severe in certain months such as March (OR: 29.5; p = 0.21) and May (OR: 475; p < 0.05).
Conclusion
Analyses confirmed unequal impact of IGAS on certain populations and revealed longer admission and seasonality play significant roles in illness severity. Early detection, investigation, and collaboration with healthcare systems and other stakeholders are key components to reducing IGAS cases.
