ArticleInfection2026
Outcomes and associated risk factors among hospitalisations attributed to invasive group A streptococcal disease in Northern Queensland, Australia: a 21-year population-based data linkage study.
Article in Infection, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeInvasive group A Streptococcus (iGAS) disease is associated with substantial morbidity and mortality. This study aimed to assess the outcomes of iGAS infection and associated risk factors in Northern Queensland, Australia.
methodsA retrospective cohort study was conducted using linked hospital data from 2000 to 2020. iGAS cases were identified using ICD-10-AM diagnosis codes in administrative health datasets. Mortality and disease burden were analysed, and risk factors for adverse outcomes were assessed using logistic regression and competing risks regression. Disability-Adjusted Life Years (DALYs) were estimated to quantify disease burden.
resultsA total of 933 iGAS related hospitalisations were identified among 870 individuals. The mean age of the cohort was 45 years (SD = 24), with a median age of 61 years (IQR: 48-77 years). Hospitalised case fatality rate was 5.2%. Intensive Care Unit (ICU) admission was required for 219 patients (23.5%). Readmissions occurred in 2.0% of cases, and 3.6% experienced recurrent infection. Most deaths were attributable to sepsis (80%), with necrotising fasciitis (18%) and septic shock (13.3%) also contributing. In multivariable analysis, age ≥ 60 years was associated with lower odds of ICU admission, while female sex, non-Indigenous status, higher Socio-Economic Indexes for Areas (SEIFA) decile, cardiac disease, and renal failure were associated with increased odds of ICU admission (p < 0.01). Older age, non-Indigenous status and renal failure were significantly associated with increased mortality (p < 0.01). The total DALY burden was 1,375 years.
conclusioniGAS imposes a substantial health burden in Northern Queensland, characterised by significant morbidity and high advanced health resource utilisation. Identification of high-risk groups highlights opportunities for targeted prevention of adverse health outcomes of iGAS.
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