Seasonal variations and risk factors of Streptococcus pyogenes infection: a multicenter research network study
Background: Streptococcus pyogenes, or Group A Streptococcus (GAS), causes acute pharyngitis and necrotizing fasciitis. Seasonal variations in GAS infections are not robustly characterized. We assessed seasonal variations and risk factors of GAS pharyngitis and ICD-10-diagnosed necrotizing fasciitis...
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| Veröffentlicht in: | Therapeutic advances in infectious disease 2022, Vol.9 |
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| creator | Kennis, Matthew Tagawa, Alex Kung, Vanessa M. Montalbano, Gabrielle Narvaez, Isabella Franco-Paredes, Carlos Vargas Barahona, Lilian Madinger, Nancy Shapiro, Leland Chastain, Daniel B. Henao-Martínez, Andrés F. |
| description | Background:
Streptococcus pyogenes, or Group A Streptococcus (GAS), causes acute pharyngitis and necrotizing fasciitis. Seasonal variations in GAS infections are not robustly characterized. We assessed seasonal variations and risk factors of GAS pharyngitis and ICD-10-diagnosed necrotizing fasciitis.
Methods:
From the period 2010–2019, we conducted a case–control study using laboratory-confirmed cases of GAS pharyngitis and a descriptive observational study of necrotizing fasciitis using ICD-10 codes. Data were collected from TriNetX, a federated research network. We extracted seasonal (quarterly) incidence rates. We used an autoregressive integrated moving average (ARIMA) model to assess seasonal variations. Demographic characteristics and 1-month outcomes were compared among adults with or without GAS pharyngitis.
Results:
We identified 224,471 adults with GAS pharyngitis (test-positive) and 546,142 adults without it (test-negative). GAS pharyngitis adults were younger (25.3 versus 30.2 years of age, p |
| doi_str_mv | 10.1177/20499361221132101 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9585558</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_20499361221132101</sage_id><sourcerecordid>2758537081</sourcerecordid><originalsourceid>FETCH-LOGICAL-c443t-55e0d5c5c06fe73febb708b4dc49fab57ce827f10b289b9c5a313bc5271112653</originalsourceid><addsrcrecordid>eNp1UU1LAzEQXUTBUvsDvAU8VzPJZrPrQRDxCwoeVPAWstlJ3X4kNclW-u_dUqmIOJcZZt5785jJslOg5wBSXjCaVxUvgDEAzoDCQTbY9sYVl2-H-7qA42wU44z2URZ9lIPMPaOO3ukFWevQ6tR6F4l2DQltnBOrTfIhEm_Jcwq4St54Y7pIVhs_RYeRtM6i2bIuiSbLbpFagy5hIAEj6mDeicP06cOcxNQ1m5PsyOpFxNF3Hmavd7cvNw_jydP94831ZGzynKexEEgbYYShhUXJLda1pGWdNyavrK6FNFgyaYHWrKzqygjNgddGMAkArBB8mF3tdFddvcRm6ynohVqFdqnDRnndqt8T176rqV-rSpRCiLIXOPsWCP6jw5jUzHehv1NUTPYY3vuBHgU7lAk-xoB2vwGo2r5G_XlNzznfcaKe4o_q_4QvXPORiA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2758537081</pqid></control><display><type>article</type><title>Seasonal variations and risk factors of Streptococcus pyogenes infection: a multicenter research network study</title><source>DOAJ Directory of Open Access Journals</source><source>SAGE Open Access Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><creator>Kennis, Matthew ; Tagawa, Alex ; Kung, Vanessa M. ; Montalbano, Gabrielle ; Narvaez, Isabella ; Franco-Paredes, Carlos ; Vargas Barahona, Lilian ; Madinger, Nancy ; Shapiro, Leland ; Chastain, Daniel B. ; Henao-Martínez, Andrés F.</creator><creatorcontrib>Kennis, Matthew ; Tagawa, Alex ; Kung, Vanessa M. ; Montalbano, Gabrielle ; Narvaez, Isabella ; Franco-Paredes, Carlos ; Vargas Barahona, Lilian ; Madinger, Nancy ; Shapiro, Leland ; Chastain, Daniel B. ; Henao-Martínez, Andrés F.</creatorcontrib><description>Background:
Streptococcus pyogenes, or Group A Streptococcus (GAS), causes acute pharyngitis and necrotizing fasciitis. Seasonal variations in GAS infections are not robustly characterized. We assessed seasonal variations and risk factors of GAS pharyngitis and ICD-10-diagnosed necrotizing fasciitis.
Methods:
From the period 2010–2019, we conducted a case–control study using laboratory-confirmed cases of GAS pharyngitis and a descriptive observational study of necrotizing fasciitis using ICD-10 codes. Data were collected from TriNetX, a federated research network. We extracted seasonal (quarterly) incidence rates. We used an autoregressive integrated moving average (ARIMA) model to assess seasonal variations. Demographic characteristics and 1-month outcomes were compared among adults with or without GAS pharyngitis.
Results:
We identified 224,471 adults with GAS pharyngitis (test-positive) and 546,142 adults without it (test-negative). GAS pharyngitis adults were younger (25.3 versus 30.2 years of age, p < 0.0001), more likely to be Hispanic individuals (10% versus 8%, p < 0.0001) and slightly more likely to be Black or African American individuals (14% versus 13%, p < 0.0001). Propensity score matching found that adults with test-positive cases of GAS pharyngitis had a higher risk of acute rheumatic fever while having no significant differences in risk of intensive care unit admission and mortality compared with test-negative cases. GAS pharyngitis average incidence peaked in the winter while dipping in the summer (0.32 versus 0.18 and 4.07 versus 1.78 per 1000 adults and pediatric patients, respectively). Necrotizing fasciitis diagnoses were highest during summer (0.032 per 1000 adults). There was a significant ARIMA seasonal variation in the time series analysis for adult and pediatric GAS pharyngitis (p < 0.0001 and p = 0.014, respectively). Necrotizing fasciitis diagnosis was not associated with seasonal variation (p = 0.861).
Conclusion:
Peaks in GAS pharyngitis occur in the winter months. ICD code–based necrotizing fasciitis did not show a quarterly seasonal variation.</description><identifier>ISSN: 2049-9361</identifier><identifier>EISSN: 2049-937X</identifier><identifier>DOI: 10.1177/20499361221132101</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Fasciitis ; Necrotizing fasciitis ; Original Research ; Pediatrics ; Pharyngitis ; Rheumatic fever ; Risk factors ; Seasonal variations ; Streptococcus infections ; Streptococcus pyogenes ; Summer ; Winter</subject><ispartof>Therapeutic advances in infectious disease, 2022, Vol.9</ispartof><rights>The Author(s), 2022</rights><rights>The Author(s), 2022. This work is licensed under the Creative Commons Attribution – Non-Commercial License https://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s), 2022 2022 SAGE Publications Ltd unless otherwise noted. Manuscript content on this site is licensed under Creative Commons Licenses</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c443t-55e0d5c5c06fe73febb708b4dc49fab57ce827f10b289b9c5a313bc5271112653</citedby><cites>FETCH-LOGICAL-c443t-55e0d5c5c06fe73febb708b4dc49fab57ce827f10b289b9c5a313bc5271112653</cites><orcidid>0000-0002-4018-0195 ; 0000-0003-3330-808X ; 0000-0001-7363-8652</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9585558/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9585558/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,4010,21945,27830,27900,27901,27902,44921,45309,53766,53768</link.rule.ids></links><search><creatorcontrib>Kennis, Matthew</creatorcontrib><creatorcontrib>Tagawa, Alex</creatorcontrib><creatorcontrib>Kung, Vanessa M.</creatorcontrib><creatorcontrib>Montalbano, Gabrielle</creatorcontrib><creatorcontrib>Narvaez, Isabella</creatorcontrib><creatorcontrib>Franco-Paredes, Carlos</creatorcontrib><creatorcontrib>Vargas Barahona, Lilian</creatorcontrib><creatorcontrib>Madinger, Nancy</creatorcontrib><creatorcontrib>Shapiro, Leland</creatorcontrib><creatorcontrib>Chastain, Daniel B.</creatorcontrib><creatorcontrib>Henao-Martínez, Andrés F.</creatorcontrib><title>Seasonal variations and risk factors of Streptococcus pyogenes infection: a multicenter research network study</title><title>Therapeutic advances in infectious disease</title><description>Background:
Streptococcus pyogenes, or Group A Streptococcus (GAS), causes acute pharyngitis and necrotizing fasciitis. Seasonal variations in GAS infections are not robustly characterized. We assessed seasonal variations and risk factors of GAS pharyngitis and ICD-10-diagnosed necrotizing fasciitis.
Methods:
From the period 2010–2019, we conducted a case–control study using laboratory-confirmed cases of GAS pharyngitis and a descriptive observational study of necrotizing fasciitis using ICD-10 codes. Data were collected from TriNetX, a federated research network. We extracted seasonal (quarterly) incidence rates. We used an autoregressive integrated moving average (ARIMA) model to assess seasonal variations. Demographic characteristics and 1-month outcomes were compared among adults with or without GAS pharyngitis.
Results:
We identified 224,471 adults with GAS pharyngitis (test-positive) and 546,142 adults without it (test-negative). GAS pharyngitis adults were younger (25.3 versus 30.2 years of age, p < 0.0001), more likely to be Hispanic individuals (10% versus 8%, p < 0.0001) and slightly more likely to be Black or African American individuals (14% versus 13%, p < 0.0001). Propensity score matching found that adults with test-positive cases of GAS pharyngitis had a higher risk of acute rheumatic fever while having no significant differences in risk of intensive care unit admission and mortality compared with test-negative cases. GAS pharyngitis average incidence peaked in the winter while dipping in the summer (0.32 versus 0.18 and 4.07 versus 1.78 per 1000 adults and pediatric patients, respectively). Necrotizing fasciitis diagnoses were highest during summer (0.032 per 1000 adults). There was a significant ARIMA seasonal variation in the time series analysis for adult and pediatric GAS pharyngitis (p < 0.0001 and p = 0.014, respectively). Necrotizing fasciitis diagnosis was not associated with seasonal variation (p = 0.861).
Conclusion:
Peaks in GAS pharyngitis occur in the winter months. ICD code–based necrotizing fasciitis did not show a quarterly seasonal variation.</description><subject>Fasciitis</subject><subject>Necrotizing fasciitis</subject><subject>Original Research</subject><subject>Pediatrics</subject><subject>Pharyngitis</subject><subject>Rheumatic fever</subject><subject>Risk factors</subject><subject>Seasonal variations</subject><subject>Streptococcus infections</subject><subject>Streptococcus pyogenes</subject><subject>Summer</subject><subject>Winter</subject><issn>2049-9361</issn><issn>2049-937X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>AFRWT</sourceid><sourceid>BENPR</sourceid><recordid>eNp1UU1LAzEQXUTBUvsDvAU8VzPJZrPrQRDxCwoeVPAWstlJ3X4kNclW-u_dUqmIOJcZZt5785jJslOg5wBSXjCaVxUvgDEAzoDCQTbY9sYVl2-H-7qA42wU44z2URZ9lIPMPaOO3ukFWevQ6tR6F4l2DQltnBOrTfIhEm_Jcwq4St54Y7pIVhs_RYeRtM6i2bIuiSbLbpFagy5hIAEj6mDeicP06cOcxNQ1m5PsyOpFxNF3Hmavd7cvNw_jydP94831ZGzynKexEEgbYYShhUXJLda1pGWdNyavrK6FNFgyaYHWrKzqygjNgddGMAkArBB8mF3tdFddvcRm6ynohVqFdqnDRnndqt8T176rqV-rSpRCiLIXOPsWCP6jw5jUzHehv1NUTPYY3vuBHgU7lAk-xoB2vwGo2r5G_XlNzznfcaKe4o_q_4QvXPORiA</recordid><startdate>2022</startdate><enddate>2022</enddate><creator>Kennis, Matthew</creator><creator>Tagawa, Alex</creator><creator>Kung, Vanessa M.</creator><creator>Montalbano, Gabrielle</creator><creator>Narvaez, Isabella</creator><creator>Franco-Paredes, Carlos</creator><creator>Vargas Barahona, Lilian</creator><creator>Madinger, Nancy</creator><creator>Shapiro, Leland</creator><creator>Chastain, Daniel B.</creator><creator>Henao-Martínez, Andrés F.</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>AFRWT</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7U9</scope><scope>7XB</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>KB0</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-4018-0195</orcidid><orcidid>https://orcid.org/0000-0003-3330-808X</orcidid><orcidid>https://orcid.org/0000-0001-7363-8652</orcidid></search><sort><creationdate>2022</creationdate><title>Seasonal variations and risk factors of Streptococcus pyogenes infection: a multicenter research network study</title><author>Kennis, Matthew ; Tagawa, Alex ; Kung, Vanessa M. ; Montalbano, Gabrielle ; Narvaez, Isabella ; Franco-Paredes, Carlos ; Vargas Barahona, Lilian ; Madinger, Nancy ; Shapiro, Leland ; Chastain, Daniel B. ; Henao-Martínez, Andrés F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c443t-55e0d5c5c06fe73febb708b4dc49fab57ce827f10b289b9c5a313bc5271112653</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Fasciitis</topic><topic>Necrotizing fasciitis</topic><topic>Original Research</topic><topic>Pediatrics</topic><topic>Pharyngitis</topic><topic>Rheumatic fever</topic><topic>Risk factors</topic><topic>Seasonal variations</topic><topic>Streptococcus infections</topic><topic>Streptococcus pyogenes</topic><topic>Summer</topic><topic>Winter</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kennis, Matthew</creatorcontrib><creatorcontrib>Tagawa, Alex</creatorcontrib><creatorcontrib>Kung, Vanessa M.</creatorcontrib><creatorcontrib>Montalbano, Gabrielle</creatorcontrib><creatorcontrib>Narvaez, Isabella</creatorcontrib><creatorcontrib>Franco-Paredes, Carlos</creatorcontrib><creatorcontrib>Vargas Barahona, Lilian</creatorcontrib><creatorcontrib>Madinger, Nancy</creatorcontrib><creatorcontrib>Shapiro, Leland</creatorcontrib><creatorcontrib>Chastain, Daniel B.</creatorcontrib><creatorcontrib>Henao-Martínez, Andrés F.</creatorcontrib><collection>SAGE Open Access Journals</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Virology and AIDS Abstracts</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Therapeutic advances in infectious disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kennis, Matthew</au><au>Tagawa, Alex</au><au>Kung, Vanessa M.</au><au>Montalbano, Gabrielle</au><au>Narvaez, Isabella</au><au>Franco-Paredes, Carlos</au><au>Vargas Barahona, Lilian</au><au>Madinger, Nancy</au><au>Shapiro, Leland</au><au>Chastain, Daniel B.</au><au>Henao-Martínez, Andrés F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Seasonal variations and risk factors of Streptococcus pyogenes infection: a multicenter research network study</atitle><jtitle>Therapeutic advances in infectious disease</jtitle><date>2022</date><risdate>2022</risdate><volume>9</volume><issn>2049-9361</issn><eissn>2049-937X</eissn><abstract>Background:
Streptococcus pyogenes, or Group A Streptococcus (GAS), causes acute pharyngitis and necrotizing fasciitis. Seasonal variations in GAS infections are not robustly characterized. We assessed seasonal variations and risk factors of GAS pharyngitis and ICD-10-diagnosed necrotizing fasciitis.
Methods:
From the period 2010–2019, we conducted a case–control study using laboratory-confirmed cases of GAS pharyngitis and a descriptive observational study of necrotizing fasciitis using ICD-10 codes. Data were collected from TriNetX, a federated research network. We extracted seasonal (quarterly) incidence rates. We used an autoregressive integrated moving average (ARIMA) model to assess seasonal variations. Demographic characteristics and 1-month outcomes were compared among adults with or without GAS pharyngitis.
Results:
We identified 224,471 adults with GAS pharyngitis (test-positive) and 546,142 adults without it (test-negative). GAS pharyngitis adults were younger (25.3 versus 30.2 years of age, p < 0.0001), more likely to be Hispanic individuals (10% versus 8%, p < 0.0001) and slightly more likely to be Black or African American individuals (14% versus 13%, p < 0.0001). Propensity score matching found that adults with test-positive cases of GAS pharyngitis had a higher risk of acute rheumatic fever while having no significant differences in risk of intensive care unit admission and mortality compared with test-negative cases. GAS pharyngitis average incidence peaked in the winter while dipping in the summer (0.32 versus 0.18 and 4.07 versus 1.78 per 1000 adults and pediatric patients, respectively). Necrotizing fasciitis diagnoses were highest during summer (0.032 per 1000 adults). There was a significant ARIMA seasonal variation in the time series analysis for adult and pediatric GAS pharyngitis (p < 0.0001 and p = 0.014, respectively). Necrotizing fasciitis diagnosis was not associated with seasonal variation (p = 0.861).
Conclusion:
Peaks in GAS pharyngitis occur in the winter months. ICD code–based necrotizing fasciitis did not show a quarterly seasonal variation.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><doi>10.1177/20499361221132101</doi><orcidid>https://orcid.org/0000-0002-4018-0195</orcidid><orcidid>https://orcid.org/0000-0003-3330-808X</orcidid><orcidid>https://orcid.org/0000-0001-7363-8652</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Fasciitis Necrotizing fasciitis Original Research Pediatrics Pharyngitis Rheumatic fever Risk factors Seasonal variations Streptococcus infections Streptococcus pyogenes Summer Winter |
| title | Seasonal variations and risk factors of Streptococcus pyogenes infection: a multicenter research network study |
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