Epidemiology and Infection

Original Papers

High burden of invasive β-haemolytic streptococcal infections in Fiji

A. C. STEERa1 c1, A. J. W. JENNEYa1, F. OPPEDISANOa2, M. R. BATZLOFFa3, J. HARTASa3, J. PASSMOREa1, F. M. RUSSELLa1, J. H. H. KADOa4 and J. R. CARAPETISa1a5

a1 Centre for International Child Health, University of Melbourne, Victoria, Australia

a2 Murdoch Children's Research Institute, Victoria, Australia

a3 Queensland Institute of Medical Research, Queensland, Australia

a4 Fiji Ministry of Health, Suva, Fiji Islands

a5 Menzies School of Health Research, Charles Darwin University, Darwin, Australia

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 β-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.

(Accepted June 19 2007)

(Online publication July 16 2007)

Correspondence:

c1 Author for correspondence: Dr A. C. Steer, Centre for International Child Health, University of Melbourne, c/- Fiji Group A Streptococcal Project, PO Box 18009, Suva, Fiji Islands. (Email: andrew.steer@rch.org.au)

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