title: Invasive group A streptococcal disease: risk factors for adults.
abstract: We conducted a case-control study to identify risk factors for invasive group A streptococcal (GAS) infections, which can be fatal. Case-patients were identified when Streptococcus pyogenes was isolated from a normally sterile site and control subjects (two or more) were identified and matched to case-patients by using sequential-digit telephone dialing. All participants were noninstitutionalized surveillance area residents, >18 years of age. Conditional logistic regression identified the risk factors for invasive GAS infection: in adults 18 to 44 years of age, exposure to one or more children with sore throats (relative risk [RR]=4.93, p=0.02), HIV infection (RR=15.01, p=0.04), and history of injecting drug use (RR=14.71, p=0.003); in adults >45 years of age, number of persons in the home (RR=2.68, p=0.004), diabetes (RR=2.27, p=0.03), cardiac disease (RR=3.24, p=0.006), cancer (RR=3.54, p=0.006), and corticosteroid use (RR=5.18, p=0.03). Thus, host and environmental factors increased the risk for invasive GAS disease.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA. sfactor@health.nyc.gov
authors.forename: Stephanie H
authors.initials: SH
authors.lastname: Factor
authors.forename: Orin S
authors.initials: OS
authors.lastname: Levine
authors.forename: Benjamin
authors.initials: B
authors.lastname: Schwartz
authors.forename: Lee H
authors.initials: LH
authors.lastname: Harrison
authors.forename: Monica M
authors.initials: MM
authors.lastname: Farley
authors.forename: Allison
authors.initials: A
authors.lastname: McGeer
authors.forename: Anne
authors.initials: A
authors.lastname: Schuchat
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002648:Child; D004781:Environmental Exposure; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012307:Risk Factors; D013290:Streptococcal Infections / Q000453:epidemiology / Q000209:etiology*; D013297:Streptococcus pyogenes / Q000302:isolation & purification*; D015819:Substance Abuse, Intravenous; D011795:Surveys and Questionnaires