Streptococcal Infections Increased in U.S. From 2013 to 2022, Study Finds

A new study published in JAMA found that overall incidence of streptococcal infections increased in the U.S. from 2013 through 2022.

Invasive group A Streptococcus (GAS) infections are “associated with substantial morbidity, mortality, and economic burden.” Researchers analyzed surveillance collected by the Active Bacterial Core surveillance network covering 34.9 million persons across 10 U.S. states. Cases were defined as “isolation of GAS from a normally sterile site or from a wound in a patient with necrotizing fasciitis or streptococcal toxic shock syndrome” from 2013 to 2022. Whole-genome sequencing was used from 2015 on.

Across those 10 states, there were 21,312 cases of invasive GAS over that time, with 1,981 deaths reported. 63.7% of the cases were in people aged 18 to 64 and 30.4% were in people 65 years of age or older. Incidence “rose from 3.6 per 100,000 persons in 2013 to 8.2 per 100,000 persons in 2022.” Incidence was “highest among persons 65 years or older; however, the relative increase over time was greatest among adults aged 18 to 64 years.” It was also higher among “American Indian or Alaska Native persons than in other racial and ethnic groups.” Other groups at high risk included “people experiencing homelessness, people who inject drugs, and residents of long-term care facilities.”

The authors of the study concluded that “accelerated efforts to prevent and control GAS are needed, especially among groups at highest risk of infection.”