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Volume 17, Number 6—June 2011

Invasive Group A Streptococcal Infection and Vaccine Implications, Auckland, New Zealand

Atheer Safar, Diana LennonComments to Author , Joanna Stewart, Adrian Trenholme, Dragana Drinkovic, Briar Peat, Susan Taylor, Kerry Read, Sally Roberts, and Lesley Voss
Author affiliations: Author affiliations: Auckland City Hospital, Auckland, New Zealand (A. Safar, S. Roberts); The University of Auckland, Auckland (D. Lennon, J. Stewart); Kidz First Children’s Hospital/Middlemore Hospital, Auckland (A. Trenholme); North Shore Hospital, Auckland (D. Drinkovic, K. Read); The University of Auckland/Middlemore Hospital, Auckland (B. Peat); Middlemore Hospital, Auckland (S. Taylor); Starship Children’s Hospital, Auckland (L. Voss)

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Table 3

Clinical syndromes and CFRs for 225 patients with invasive GAS disease, Auckland, New Zealand, 2005–2006*

Diagnosis† Age group, y
All ages, no. (%),‡ N = 225 p value§
0–14, n = 36
>15, n = 189
Skin and soft tissue infection¶ 11 0 86 8 97 (43) 0.14
Bacteremia only 7 38 31 19 38 (16) 0.63
STSS#** 6 67†† 24 54 30 (13) 0.59
Bone infection 6 0 20 0 26 (12) 0.39
Pneumonia and other respiratory infection 12 13 12 0 24 (11) 0.0001
Necrotizing fasciitis** 1 0 19 15 20 (9) 0.21
Pelvic infection/peripartum‡‡ 0 0 12 0 12 (5)

*CFR, case-fatality rate; GAS, group A streptococcal; STSS, streptococcal toxic shock syndrome.
†Patients may have had >1 diagnosis, with the exception of bacteremia without a source. Other conditions (not shown) included 4 upper airway infections 6 ear/nose/throat infections, 5 central nervous system infections, 4 cases of peritonitis, 3 urinary tract infections, and 2 hemodialysis vascular access infections. No deaths occurred in this group.
‡Overall CFR 10% (22/225).
§p value calculated by using Fisher exact test, a test of difference between age groups.
¶Includes cellulitis (n = 79), cutaneous abscess, boil, lymphadenitis, myositis, bursitis, infected burn, infected scabies, and infected ulcer with evidence of documented bacteremia.
#STSS confirmed and probable (n = 3).
**Five patients had STSS and NF; 1/5 died (20% CFR).
††Three of 6 were community deaths in infants <1 y of age.
‡‡Includes pregnancy-related (n = 6) endometritis and infected products, urinary tract infection/chorioamnionitis, and wound problems.

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Page created: August 03, 2011
Page updated: August 03, 2011
Page reviewed: August 03, 2011
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