title: High burden of invasive beta-haemolytic streptococcal infections in Fiji.
abstract: We undertook a 5-year retrospective study of group A streptococcal (GAS) bacteraemia in Fiji, supplemented by a 9-month detailed retrospective study of beta-haemolytic streptococcal (BHS) infections. The all-age incidence of GAS bacteraemia over 5 years was 11.6/100,000. Indigenous Fijians were 4.7 times more likely to present with invasive BHS disease than people of other ethnicities, and 6.4 times more likely than Indo-Fijians. The case-fatality rate for invasive BHS infections was 28%. emm-typing was performed on 23 isolates: 17 different emm-types were found, and the emm-type profile was different from that found in industrialized nations. These data support the contentions that elevated rates of invasive BHS and GAS infections are widespread in developing countries, and that the profile of invasive organisms in these settings reflects a wide diversity of emm-types and a paucity of types typically found in industrialized countries.
authors.affiliation: Centre for International Child Health, University of Melbourne, Victoria, Australia. andrew.steer@rch.org.au
authors.forename: A C
authors.initials: AC
authors.lastname: Steer
authors.forename: A J W
authors.initials: AJ
authors.lastname: Jenney
authors.forename: F
authors.initials: F
authors.lastname: Oppedisano
authors.forename: M R
authors.initials: MR
authors.lastname: Batzloff
authors.forename: J
authors.initials: J
authors.lastname: Hartas
authors.forename: J
authors.initials: J
authors.lastname: Passmore
authors.forename: F M
authors.initials: FM
authors.lastname: Russell
authors.forename: J H H
authors.initials: JH
authors.lastname: Kado
authors.forename: J R
authors.initials: JR
authors.lastname: Carapetis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000942:Antigens, Bacterial / Q000235:genetics; D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology* / Q000401:mortality; D001425:Bacterial Outer Membrane Proteins / Q000235:genetics; D015373:Bacterial Typing Techniques; D002352:Carrier Proteins / Q000235:genetics; D002648:Child; D002675:Child, Preschool; D004269:DNA, Bacterial; D005006:Ethnicity; D005260:Female; D005367:Fiji / Q000453:epidemiology; D005838:Genotype; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013290:Streptococcal Infections / Q000453:epidemiology* / Q000382:microbiology* / Q000401:mortality; D013297:Streptococcus pyogenes / Q000302:isolation & purification*
chemical_list: D000942:Antigens, Bacterial; D001425:Bacterial Outer Membrane Proteins; D002352:Carrier Proteins; D004269:DNA, Bacterial; C014689:streptococcal M protein