Clinical and epidemiological features of group A streptococcal bacteraemiain a region with hyperendemic superficial streptococcal infection

Reports of increasing incidence and severity of invasive group A streptococ cal (GAS) infections come mainly from affluent populations where exposure t o GAS is relatively infrequent. We conducted a B-year retrospective review of GAS bacteraemia in the Northern Territory of Australia, comparing the Ab original population (24% of the study population), who have high rates of o ther streptococcal infections and sequelae, to the non-Aboriginal populatio n. Of 72 episodes, 44 (61%) were in Aboriginal patients. All 12 cases in ch ildren were Aboriginal. Risk factors were implicated in 82 % of episodes (9 1 % in adults) and there was no significant difference in the proportion of Aboriginal compared to non-Aboriginal patients with at least one risk fact or. Genetic typing of isolates revealed no dominant strains and no evidence of a clone which has been a common cause of these infections elsewhere.