Epidemiological features of invasive and noninvasive group A streptococcal disease in the Netherlands, 1992-1996.
A prospective, nationwide, laboratory-based surveillance of invasive group A streptococcal infections was conducted in the Netherlands from 1992 through 1996. Clinical and demographic data were obtained and all isolates were T/M typed. All noninvasive group A streptococcal isolates were registered from 1994 through 1996. A total of 880 patients with invasive streptococcal disease were identified. The annual incidence was found to be 2.2 per 100,000. Predominant M types were M1 (21%), M3 (11%), M6 (5%), M12 (5%), and M28 (8%). Particular age and M-type distributions were observed in different clinical entities. The case-fatality rate was 18% overall, but it reached 59% among cases of toxic shock-like syndrome. Older age, necrotizing fasciitis, sepsis without focus, pneumonia, infection with type M1 or M3 strains, and underlying cardiopulmonary disease were associated with fatality. A total of 10,105 patients with noninvasive group A streptococcal disease were registered. These patients differed significantly from patients with invasive disease with regard to age distribution and primary foci of infection.
Vlaminckx
B
B
Eijkman Winkler Institute for Medical Microbiology, Infectious Diseases and Inflammation, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. b.j.m.vlaminckx@lab.azu.nl
van Pelt
W
W
Schouls
L
L
van Silfhout
A
A
Elzenaar
C
C
Mascini
E
E
Verhoef
J
J
Schellekens
J
J
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents; D016470:Bacteremia / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination / Q000008:administration & dosage; D019115:Fasciitis, Necrotizing / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D013290:Streptococcal Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D013297:Streptococcus pyogenes / Q000302:isolation & purification*
D000900:Anti-Bacterial Agents