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Volume 28, Number 9—September 2022
CME ACTIVITY - Research

Increasing Incidence of Invasive Group A Streptococcus Disease, Idaho, USA, 2008–2019

Eileen M. Dunne, Scott Hutton, Erin Peterson, Anna J. Blackstock, Christine G. Hahn, Kathryn Turner, and Kris K. CarterComments to Author 
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (E.M. Dunne, A.J. Blackstock, K.K. Carter); Idaho Department of Health and Welfare, Boise, Idaho, USA (E.M. Dunne, S. Hutton, E. Peterson, C.G. Hahn, K. Turner, K.K. Carter)

Main Article

Table 2

Individual risk factor and multivariable analysis of risk factors comparing invasive group A Streptococcus cases during 2014–2019 with cases from the 2008–2013 baseline period, Idaho, USA

Variable Unadjusted odds ratio* (95% CI) p value Adjusted odds ratio† (95% CI) p value
Sex
F Referent
M
1.4 (0.9–2.2)
0.16


Age group, y
0–17 1.2 (0.5–2.8) 0.71 1.3 (0.5–3.3) 0.63
18–49 Referent Referent
50–64 1.2 (0.6–2.3) 0.65 1.6 (0.7–3.8) 0.29
65–79 1.7 (0.9–3.2) 0.13 1.7 (0.8–3.8) 0.16
≥80
1.1 (0.5–2.1)
0.90
1.1 (0.5–2.6)
0.84
Ethnicity
Non-Hispanic Referent
Hispanic
2.4 (0.5–10.4)
0.25


Residence type
Private Referent Referent
Long-term care or nursing facility 0.7 (0.4–1.4) 0.37 0.7 (0.3–1.5) 0.33
Correctional facility 1.2 (0.1–9.7) 0.90 1.9 (0.1–36.7) 0.67
Homeless
1.5 (0.2–12.5)
0.69
0.7 (0.1–4.8)
0.74
Underlying conditions
Diabetes 0.9 (0.5–1.5) 0.68
Heart disease: congestive heart failure or coronary artery disease 1.3 (0.7–2.3) 0.46
Obesity 1.3 (0.7–2.4) 0.49 1.2 (0.6–2.5) 0.58
Chronic kidney disease or failure 1.6 (0.7–3.6) 0.30
Chronic obstructive pulmonary disease 0.8 (0.4–1.8) 0.62
Cancer 2.4 (0.7–7.9) 0.17
Immunosuppression 2.0 (0.5–8.6) 0.37
Hepatitis C or chronic liver disease 1.5 (0.4–6.9) 0.57
Other‡ 2.3 (0.3–18.2) 0.42
Any underlying condition
0.9 (0.5–1.7)
0.75


Other risk factors
Skin injury 1.0 (0.6–1.7) 0.97
Cigarette smoking 0.9 (0.5–1.9) 0.82
Alcohol abuse 0.9 (0.3–2.3) 0.75
Injection drug use 3.4 (0.2–60.0) 0.40 3.2 (0.2–63.0) 0.45

*Standard logistic regression analysis performed unless otherwise noted. An odds ratio >1 indicates higher odds of being in the 2014–2019 period. †Firth logistic regression used to account for separation attributable to limited sample size and highly predictive risk factors. For multivariable analysis, results for residence type and injection drug use represent total effect and results for age group and obesity represent direct effect. ‡Other underlying conditions include paralysis, neurologic conditions, and developmental delay.

Main Article

Page created: July 15, 2022
Page updated: August 22, 2022
Page reviewed: August 22, 2022
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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