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Prospective surveillance for invasive Staphylococcus aureus and group A Streptococcus infections in a setting with high community burden of scabies and impetigo

Invasive Staphylococcus aureus (iSA) and group A Streptococcus (iGAS) impose significant health burdens globally. Both bacteria commonly cause skin and soft tissue infections (SSTIs), which can result in invasive disease. Understanding of the incidence of iSA and iGAS remains limited in settings with a high SSTI burden.

Time to address the neglected burden of group A Streptococcus

Jonathan Jeffrey Carapetis AM Cannon AM MBBS FRACP FAFPHM PhD FAHMS BSc(Hons) BBus PhD Executive Director; Co-Head, Strep A Translation; Co-Founder

An update on the burden of group A streptococcal diseases in Australia and vaccine development

Asha Jeffrey Bowen Cannon BA MBBS DCH FRACP PhD GAICD FAHMS OAM BSc(Hons) BBus PhD Head, Healthy Skin and ARF Prevention Health Economist

Increasing incidence of invasive group A streptococcal disease in Western Australia, particularly among Indigenous people

The incidence of invasive GAS disease in WA increased between 2000 and 2018, particularly among Indigenous Australians. Mandatory notification of invasive GAS disease would therefore be appropriate. The social determinants of differences in incidence should be addressed, and other relevant host, pathogen, and health system factors investigated.

Formative evaluation of a community-based approach to reduce the incidence of Strep A infections and acute rheumatic fever

We explore the acceptability of a novel, outreached-based approach to improve primary and primordial prevention of Strep A skin sores, sore throats and acute rheumatic fever in remote Aboriginal communities. A comprehensive prevention program delivered by trained Aboriginal Community Workers was evaluated using approximately fortnightly household surveys about health and housing and clinical records.

Revisiting the inoculum effect for Streptococcus pyogenes with a hollow fibre infection model

Severe, invasive Streptococcus pyogenes (Strep A) infections result in greater than 500,000 deaths annually. First line treatment for such infections is benzylpenicillin, often with the addition of clindamycin, but treatment failure can occur with this regimen. This failure has been partially attributed to the inoculum effect, which presents as reduced antibiotic susceptibility during high bacterial density and plateau-phase growth.

Increased burden of invasive group A streptococcal disease among Australian children, 2023–2024: a prospective cohort study

Global rates of invasive Group A Streptococcus (iGAS) disease surged from September 2022, exceeding pre-COVID-19 pandemic levels, showing atypical seasonality and disproportionately affecting children. We previously described the epidemiology of iGAS among Australian children from mid-2018 to end 2022 using data from the Paediatric Active Enhanced Diseases network and here provide updated clinical epidemiology for 2023 and 2024 to help inform public health strategies.

Challenges and insights in self-swab surveillance for asymptomatic Streptococcus pyogenes carriage

Asymptomatic carriage of Streptococcus pyogenes (Strep A) may contribute to transmission, yet its role remains poorly understood and evidence on optimal detection methods is limited. While self-collected throat swabs are used in infectious disease surveillance, their value for identifying asymptomatic Strep A carriage in adults is uncertain. This pilot prospective cohort study, conducted at a Perth medical research institute between August and October 2024, assessed feasibility and acceptability of self-collection, with sensitivity as a secondary objective. 

Country-level and global burden of diseases caused by group A Streptococcus: protocol for a multicountry epidemiological study

Group A Streptococcus (Strep A) causes a wide spectrum of diseases, ranging from pharyngitis and impetigo to severe invasive infections and immune-mediated conditions such as acute rheumatic fever, rheumatic heart disease and acute post-streptococcal glomerulonephritis. Contemporary data on the global burden of Strep A diseases are lacking.

Acute rheumatic fever

Acute rheumatic fever is an autoimmune disorder resulting from Group A Streptococcus pharyngitis or impetigo in children and adolescents, which may evolve to rheumatic heart disease (RHD) with persistent cardiac valve damage. RHD causes substantial mortality and morbidity globally, predominantly among socioeconomically disadvantaged populations, with an interplay of social determinants of health and genetic factors determining overall risk.