Reports of increasing incidence and severity of invasive group
A streptococcal (GAS) infections
come mainly from affluent populations where exposure to GAS is relatively
infrequent. We
conducted a 6-year retrospective review of GAS bacteraemia in the Northern
Territory of
Australia, comparing the Aboriginal population (24% of the study population),
who have high
rates of other streptococcal infections and sequelae, to the non-Aboriginal
population. Of 72
episodes, 44 (61%) were in Aboriginal patients. All 12 cases in children
were Aboriginal. Risk
factors were implicated in 82% of episodes (91% in adults) and there was
no significant
difference in the proportion of Aboriginal compared to non-Aboriginal patients
with at least
one risk factor. Genetic typing of isolates revealed no dominant strains
and no evidence of a
clone which has been a common cause of these infections elsewhere.