ABCs Report: group A Streptococcus, 2010

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Active Bacterial Core Surveillance (ABCs): Emerging Infections Program Network

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^¶Surveillance Note

At the start of this surveillance year (2010), missing race (n=218) and deaths (n=2) data were multiply imputed using sequential regression imputation methods. Previously, missing race data were distributed in the same proportion as known cases. For comparison, view the 2010 surveillance report based on the previous method.

ABCs Areas

California (3 county San Francisco Bay area); Colorado (5 county Denver area); Connecticut; Georgia (20 county Atlanta area); Maryland (6 county Baltimore area); Minnesota; New Mexico; New York (15 county Rochester and Albany areas); Oregon (3 county Portland area); Tennessee (20 urban counties)

ABCs Population

The surveillance areas represent 32,103,140 persons. Source: National Center for Health Statistics bridged-race vintage 2010 postcensal file

ABCs Case Definition

Invasive group A streptococcal disease: isolation of group A Streptococcus from a normally sterile site or from a wound culture accompanied by necrotizing fasciitis or streptococcal toxic shock syndrome in a resident of a surveillance area in 2010.

ABCs Methodology

ABCs personnel routinely contacted all microbiology laboratories serving acute care hospitals in their area to identify cases. Standardized case report forms that include information on demographic characteristics, clinical syndrome, and outcome of illness were completed for each identified case. Strains were emm typed at CDC. Regular laboratory audits assessed completeness of active surveillance and detected additional cases.

All rates of invasive group A streptococcal disease were calculated using population estimates for 2010. For national estimates of cases, race- and age-specific rates of disease were applied from the aggregate surveillance area to the age and racial distribution of the 2010 U.S. population. Cases with missing data, excluding ethnicity, were multiply imputed using the sequential regression imputation method.^¶

Reported ABCs Profiles

Race	No.	(Rate^*)
White	961	(3.9)
Black	237	(4.7)
Other	90	(3.4)

^*Cases per 100,000 population for ABCs areas

Ethnicity	No.	(Rate^*)
Hispanic	147	(3.6)
Non-Hispanic	720	-
Unknown	421	-

^*Cases per 100,000 population for ABCs areas

Age (years)	Cases No. (Rate^*)	Deaths No. (Rate^*)
<1	21 (5.2)	1 (0.25)
1	24 (5.8)	0 (0.00)
2-4	36 (2.8)	1 (0.08)
5-17	93 (1.7)	2 (0.04)
18-34	145 (1.9)	5 (0.07)
35-49	277 (4.0)	17 (0.24)
50-64	306 (5.0)	37 (0.60)
≥ 65	386 (10.0)	62 (1.61)
Total	1,288 (4.0)	125 (0.39)

^*Cases or deaths per 100,000 population for ABCs areas

ABCs Area^*	Most common emm types^†	% of area isolates
California	82, 1, 75, 28, 12, 89	69.4
Colorado	1, 3, 28, 4, 118, 2	62.1
Georgia	1, 3, 89, 12, 6	74.2
Maryland	1, 89, 6, 77, 3, 76	65.5
Minnesota	1, 118, 12, 28, 4, 5	63.6
New Mexico	1, 118, 12, 3, 58	59.3
New York	1, 89, 12, 3, 11, 28, 6, 118	90.3
Oregon	1, 28, 11, 89, 4, 82	68.1
Tennessee	1, 3, 89, 4, 12, 6	75.8
Total	1, 3, 89, 12, 28	54.3

^*Connecticut contributed cases but no isolates
^†Requires a minimum of 3 or more isolates and ≥ 5% of isolates typed

Syndrome	No.	(%)
Cellulitis	477	(37.0)
Necrotizing fasciitis	74	(5.7)
Pneumonia	200	(15.5)
Primary bacteremia	290	(22.5)
Streptococcal toxic shock	42	(3.3)

Note: Some cases had more than one syndrome.

Potentially preventable invasive group A streptococcal (GAS) disease

During 2010, zero cases of invasive GAS disease were detected in patients with varicella.

National Estimates of Invasive GAS Disease

Cases: 12,500 (4.0/100,000)
Deaths: 1,250 (0.4/100,000)

Citation

Centers for Disease Control and Prevention. 2012. Active Bacterial Core Surveillance Report, Emerging Infections Program Network, Group A Streptococcus, 2010.

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