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Outbreak of Invasive Infections From Subtype emm26.3 Group A Streptococcus Among Homeless Adults-Anchorage, Alaska, 2016-2017.
Mosites, Emily; Frick, Anna; Gounder, Prabhu; Castrodale, Louisa; Li, Yuan; Rudolph, Karen; Hurlburt, Debby; Lecy, Kristen D; Zulz, Tammy; Adebanjo, Tolu; Onukwube, Jennifer; Beall, Bernard; Van Beneden, Chris A; Hennessy, Thomas; McLaughlin, Joseph; Bruce, Michael G.
Afiliación
  • Mosites E; Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska.
  • Frick A; Section of Epidemiology, Division of Public Health, Alaska Department of Health and Social Services, Anchorage, Atlanta, Georgia.
  • Gounder P; Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska.
  • Castrodale L; Section of Epidemiology, Division of Public Health, Alaska Department of Health and Social Services, Anchorage, Atlanta, Georgia.
  • Li Y; Respiratory Disease Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
  • Rudolph K; Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska.
  • Hurlburt D; Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska.
  • Lecy KD; Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska.
  • Zulz T; Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska.
  • Adebanjo T; Respiratory Disease Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
  • Onukwube J; Respiratory Disease Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
  • Beall B; Respiratory Disease Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
  • Van Beneden CA; Respiratory Disease Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
  • Hennessy T; Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska.
  • McLaughlin J; Section of Epidemiology, Division of Public Health, Alaska Department of Health and Social Services, Anchorage, Atlanta, Georgia.
  • Bruce MG; Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska.
Clin Infect Dis ; 66(7): 1068-1074, 2018 03 19.
Article en En | MEDLINE | ID: mdl-29069346
Background: In 2016, we detected an outbreak of group A Streptococcus (GAS) invasive infections among the estimated 1000 persons experiencing homelessness (PEH) in Anchorage, Alaska. We characterized the outbreak and implemented a mass antibiotic intervention at homeless service facilities. Methods: We identified cases through the Alaska GAS laboratory-based surveillance system. We conducted emm typing, antimicrobial susceptibility testing, and whole-genome sequencing on all invasive isolates and compared medical record data of patients infected with emm26.3 and other emm types. In February 2017, we offered PEH at 6 facilities in Anchorage a single dose of 1 g of azithromycin. We collected oropharyngeal and nonintact skin swabs on a subset of participants concurrent with the intervention and 4 weeks afterward. Results: From July 2016 through April 2017, we detected 42 invasive emm26.3 cases in Anchorage, 35 of which were in PEH. The emm26.3 isolates differed on average by only 2 single-nucleotide polymorphisms. Compared to other emm types, infection with emm26.3 was associated with cellulitis (odds ratio [OR], 2.5; P = .04) and necrotizing fasciitis (OR, 4.4; P = .02). We dispensed antibiotics to 391 PEH. Colonization with emm26.3 decreased from 4% of 277 at baseline to 1% of 287 at follow-up (P = .05). Invasive GAS incidence decreased from 1.5 cases per 1000 PEH/week in the 6 weeks prior to the intervention to 0.2 cases per 1000 PEH/week in the 6 weeks after (P = .01). Conclusions: In an invasive GAS outbreak in PEH in Anchorage, mass antibiotic administration was temporally associated with reduced invasive disease cases and colonization prevalence.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones Estreptocócicas / Personas con Mala Vivienda / Brotes de Enfermedades / Administración Masiva de Medicamentos / Antibacterianos Tipo de estudio: Incidence_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Aspecto: Determinantes_sociais_saude Límite: Adolescent / Adult / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Clin Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones Estreptocócicas / Personas con Mala Vivienda / Brotes de Enfermedades / Administración Masiva de Medicamentos / Antibacterianos Tipo de estudio: Incidence_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Aspecto: Determinantes_sociais_saude Límite: Adolescent / Adult / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Clin Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos