ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2018
Outbreak of Invasive Infections From Subtype emm26.3 Group A Streptococcus Among Homeless Adults-Anchorage, Alaska, 2016-2017.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
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Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Exploring strategies and approaches to improve end-of-life care services for people experiencing homelessness: a systematic review and meta-synthesis of qualitative studies.BMC palliative care · 2026Pooled it
- Infectious Diseases Among People Experiencing Homelessness: A Systematic Review of the Literature in the United States and Canada, 2003-2022.Public health reports (Washington, D.C. : 1974)Pooled it
- Group A Streptococcus Disease Outbreak Associated with Large Congregate Shelter, Chicago, Illinois, USA, October 2023-January 2024.Emerging infectious diseases · 2026Review
- Invasive Group A Streptococcal Disease in Persons Experiencing Postpandemic Homelessness in Canada.JAMA network open · 2026Article
- Schiff base metal complexes as emerging therapeutics against antimicrobial-resistant skin pathogens.ADMET & DMPK · 2026Review
- Successful Transition to Whole-Genome Sequencing and Bioinformatics to Identify Invasive Streptococcus spp. Drug Resistance, Alaska, USA.Emerging infectious diseases · 2025Article
- Invasive Pneumococcal Disease and Potential Impact of Pneumococcal Conjugate Vaccines Among Adults, Including Persons Experiencing Homelessness-Alaska, 2011-2020.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Insights gained from sequencing Australian non-invasive and invasiveMicrobial genomics · 2024Article
- Incidence and clinical and microbiological features of invasive and probable invasive streptococcal group A infections in children and adults in the Brussels-Capital Region, 2005-2020.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2023Article
- Increasing Incidence of Invasive Group A Streptococcus Disease, Idaho, USA, 2008-2019.Emerging infectious diseases · 2022Article
- Invasive group A streptococcal disease surveillance in Canada, 2020.Canada communicable disease report = Releve des maladies transmissibles au Canada · 2022Article
- Effectiveness and Safety of Antibiotic Prophylaxis for Persons Exposed to Cases of Invasive Group A Streptococcal Disease: A Systematic Review.Open forum infectious diseases · 2022Review
- Acute Rheumatic Fever and Rheumatic Heart Disease: Highlighting the Role of Group A Streptococcus in the Global Burden of Cardiovascular Disease.Pathogens (Basel, Switzerland) · 2022Review
- Invasive Group A Streptococcal Infections Among People Who Inject Drugs and People Experiencing Homelessness in the United States, 2010-2017.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Musculoskeletal Injuries and Conditions Among Homeless Patients.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2021Review
- Differentiating Upper Extremity Necrotizing Soft Tissue Infection From Serious Cellulitis and Abscess.Cureus · 2021Article
- A Review ofPathogens (Basel, Switzerland) · 2021Review
- Experiences from the SARS-CoV-2 Pandemic: How One Orthopaedic Practice Pivoted to Serve Their Community.The Journal of bone and joint surgery. American volume · 2020Article
- Communicable disease among people experiencing homelessness in California.Epidemiology and infection · 2020Article
- Evaluating Household Transmission of Invasive Group A Streptococcus Disease in the United States Using Population-based Surveillance Data, 2013-2016.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
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Authors and funding
16 authors at 4 institutions in 1 country.
Funding
Abstract
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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