{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T21:58:20Z","timestamp":1789855100466,"version":"4.0.1"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2014,10,29]],"date-time":"2014-10-29T00:00:00Z","timestamp":1414540800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2015,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Invasive group <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content> streptococcus (<jats:styled-content style=\"fixed-case\">iGAS<\/jats:styled-content>) disease is an important cause of mortality globally. The incidence of i<jats:styled-content style=\"fixed-case\">GAS<\/jats:styled-content> in <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>ustralia's tropical <jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>orthern <jats:styled-content style=\"fixed-case\">T<\/jats:styled-content>erritory (<jats:styled-content style=\"fixed-case\">NT<\/jats:styled-content>) has been previously reported as 32.2\/100\u00a0000 in Indigenous people for the period 1991\u20131996. We aimed to measure the incidence and severity of i<jats:styled-content style=\"fixed-case\">GAS<\/jats:styled-content> disease in the <jats:styled-content style=\"fixed-case\">NT<\/jats:styled-content> since this time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We collected demographic data for all <jats:styled-content style=\"fixed-case\">GAS<\/jats:styled-content> blood culture isolates over a 12\u2010year period (1998\u20132009) from the three hospital laboratories serving the tropical <jats:styled-content style=\"fixed-case\">NT<\/jats:styled-content>. We then collected detailed clinical information from hospital records and databases for the subset of these patients who were admitted to <jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>oyal <jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>arwin <jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>ospital during 2005\u20132009.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 295 confirmed cases of <jats:styled-content style=\"fixed-case\">GAS<\/jats:styled-content> bacteraemia over the study period, with a mean (<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>) age of 42.1 (22.0) years, and 163 (55.0%) were male. The annual age\u2010adjusted incidence was 15.2 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 13.4\u201316.9)\/100\u00a0000 overall and 59.4 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 51.2\u201367.6) in <jats:styled-content style=\"fixed-case\">I<\/jats:styled-content>ndigenous <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>ustralians. For 2005\u20132009, there were 123 cases with the most common focus of infection being skin\/soft tissue [44 (35.6%)]; 29 patients (23.6%) required intensive care unit admission and 20 (16.3%) had streptococcal toxic shock syndrome. Antecedent sore throat or use of non\u2010steroidal anti\u2010inflammatory drugs was rare, but current or recent scabies, pyoderma and trauma were common.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The incidence and severity of <jats:styled-content style=\"fixed-case\">iGAS<\/jats:styled-content> are high and increasing in tropical northern Australia, and urgent attention is needed to improve surveillance and the social determinants of health in this population. This study adds to emerging data suggesting increasing importance of <jats:styled-content style=\"fixed-case\">iGAS<\/jats:styled-content> in low\u2010 and middle\u2010income settings globally.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.12405","type":"journal-article","created":{"date-parts":[[2014,10,30]],"date-time":"2014-10-30T03:39:16Z","timestamp":1414640356000},"page":"40-47","source":"Crossref","is-referenced-by-count":32,"title":["Changes in the clinical and epidemiological features of group <scp>A<\/scp> streptococcal bacteraemia in <scp>A<\/scp>ustralia's <scp>N<\/scp>orthern <scp>T<\/scp>erritory"],"prefix":"10.1111","volume":"20","author":[{"given":"R. J.","family":"Gear","sequence":"first","affiliation":[{"name":"Royal Darwin Hospital Darwin NT Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. C.","family":"Carter","sequence":"additional","affiliation":[{"name":"Royal Darwin Hospital Darwin NT Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. R.","family":"Carapetis","sequence":"additional","affiliation":[{"name":"Royal Darwin Hospital Darwin NT Australia"},{"name":"Centre for Child Health Research Telethon Institute for Child Health University of Western Australia Perth WA Australia"},{"name":"Menzies School of Health Research Charles Darwin University Darwin NT Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Baird","sequence":"additional","affiliation":[{"name":"Royal Darwin Hospital Darwin NT Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. S.","family":"Davis","sequence":"additional","affiliation":[{"name":"Royal Darwin Hospital Darwin NT Australia"},{"name":"Menzies School of Health Research Charles Darwin University Darwin NT Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,10,29]]},"reference":[{"key":"e_1_2_6_2_1","volume-title":"Australian and New Zealand Dialysis and Transplant Registry Annual Report 2007","author":"ANZDATA","year":"2007"},{"key":"e_1_2_6_3_1","volume-title":"Northern Territory from 2006 and 2011 Census of Population and Housing","author":"Australian Bureau of Statistics","year":"2007"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa040275"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.101.6.1644"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4899-1825-3_56"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/21.5.1220"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.1996.tb122012.x"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-199705000-00008"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1086\/515114"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268898001952"},{"key":"e_1_2_6_12_1","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1016\/S1473-3099(05)70267-X","article-title":"The global burden of group A streptococcal diseases","volume":"5","author":"Carapetis JR","year":"2005","journal-title":"Lancet"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1086\/376630"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2011.tb03088.x"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(80)91832-2"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60914-4"},{"key":"e_1_2_6_17_1","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1681\/ASN.V95869","article-title":"EPIBACDIAL: a multicenter prospective study of risk factors for bacteremia in chronic hemodialysis patients","volume":"9","author":"Hoen B","year":"1998","journal-title":"Journal of the American Society of Nephrology"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1993.03500030082037"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1574-695X.2010.00652.x"},{"key":"e_1_2_6_20_1","first-page":"309","article-title":"Sampling variance of standardized mortality rates","volume":"38","author":"Keyfitz N","year":"1966","journal-title":"Human Biology"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00422-08"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1086\/506938"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-011-1226-x"},{"key":"e_1_2_6_24_1","first-page":"148","article-title":"Invasive group A streptococcal disease in North Queensland (1996\u20132001)","volume":"119","author":"Norton R","year":"2004","journal-title":"Indian Journal of Medical Research"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2007.tb01054.x"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2011.03624.x"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1017\/S095026880700917X"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid15\/2.080558"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(09)70178-1"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.2165\/11634180-000000000-00000"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s101560100012"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/158.1.23"},{"key":"e_1_2_6_33_1","unstructured":"StevensDL SextonDJ&BaronEL(2011)Group A streptococcal (Streptococcus pyogenes) bacteremia in adults. Up To Date.www.uptodate.com. Accessed 24 February 2013."},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1754.1995.tb00795.x"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1753-6405.2008.00158.x"},{"key":"e_1_2_6_36_1","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1007\/BF01709751","article-title":"The SOFA (Sepsis\u2010related Organ Failure Assessment) score to describe organ dysfunction\/failure","volume":"7","author":"Vincent JL","year":"1996","journal-title":"Intensive Care Medicine"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268810001378"},{"key":"e_1_2_6_38_1","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1001\/jama.1993.03500030088038","article-title":"Defining the group A streptococcal toxic shock syndrome. Rationale and consensus definition","volume":"269","author":"Working Group on Severe Streptococcal Infections","year":"1993","journal-title":"Journal of the American Medical Association"},{"key":"e_1_2_6_39_1","doi-asserted-by":"crossref","DOI":"10.30875\/b469a751-en","volume-title":"The World Health Report 2004","author":"World Health Organization","year":"2004"},{"key":"e_1_2_6_40_1","first-page":"6","article-title":"Increase in invasive Streptococcus pyogenes and Streptococcus pneumonia infections in England, December 2010 to January 2011","volume":"16","author":"Zakikhany K","year":"2011","journal-title":"Euro Surveillance"},{"key":"e_1_2_6_41_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-199912000-00014"}],"container-title":["Tropical Medicine &amp; International Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Ftmi.12405","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.12405","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,30]],"date-time":"2023-09-30T00:10:32Z","timestamp":1696032632000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tmi.12405"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,10,29]]},"references-count":40,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2015,1]]}},"alternative-id":["10.1111\/tmi.12405"],"URL":"https:\/\/doi.org\/10.1111\/tmi.12405","archive":["Portico"],"relation":{},"ISSN":["1360-2276","1365-3156"],"issn-type":[{"value":"1360-2276","type":"print"},{"value":"1365-3156","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,10,29]]}}}