Invasive group a streptococcal infections in Ontario, Canada
Invasive group a streptococcal infections in Ontario, Canada
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DOI：
10.1056/nejm199608223350803
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发表时间：
1996-08-22
影响因子：
158.5
通讯作者：
Naus, M
中科院分区：
文献类型：
--
作者：
Davies, HD;McGeer, A;Naus, M
背景一些报告表明，侵袭性A组链球菌感染，包括链球菌中毒性休克综合征和坏死性筋膜炎，发病率increasing.Methods在1992年和1993年期间，我们进行了前瞻性，以人群为基础的监测侵袭性A组链球菌疾病在加拿大安大略。我们回顾了临床和实验室记录，寻找继发病例的侵袭性疾病，并培养标本从家庭contacts.Results我们确定了323例侵袭性A组链球菌感染，每年发病率为1.5例每10万人口。儿童和老年人的发病率最高。五十六的患者患有潜在的慢性疾病。疾病的危险因素包括感染人类免疫缺陷病毒、癌症、糖尿病、酗酒和水痘。最常见的临床表现是软组织感染（48%），无脓毒症病灶的菌血症（14%）和肺炎（11%）。6%的患者发生坏死性筋膜炎，13%发生中毒性休克。总的死亡率为15%，但64岁以上的死亡率为29%（P
Background Several reports suggest that the incidence of invasive group A streptococcal infections, including streptococcal toxic shock syndrome and necrotizing fasciitis, is increasing.Methods During 1992 and 1993 we conducted prospective, population-based surveillance of invasive group A streptococcal disease in Ontario, Canada. We reviewed clinical and laboratory records, searched for secondary cases of invasive disease, and cultured specimens from household contacts.Results We identified 323 patients with invasive group A streptococcal infections, for an annual incidence of 1.5 cases per 100,000 population. The rates were highest in young children and the elderly. Fifty-six percent of the patients had underlying chronic illness. Risk factors for disease included infection with the human immunodeficiency virus, cancer, diabetes, alcohol abuse, and chickenpox. The most common clinical presentations were soft-tissue infection (48 percent), bacteremia with no septic focus (14 percent), and pneumonia (11 percent). Necrotizing fasciitis occurred in 6 percent of patients, and toxic shock in 13 percent. The mortality rate was 15 percent overall, but it was 29 percent among those over 64 years of age (P