Invasive group A streptococcal disease: risk factors for adults

Emerg Infect Dis. 2003 Aug;9(8):970-7. doi: 10.3201/eid0908.020745.


We conducted a case-control study to identify risk factors for invasive group A streptococcal (GAS) infections, which can be fatal. Case-patients were identified when Streptococcus pyogenes was isolated from a normally sterile site and control subjects (two or more) were identified and matched to case-patients by using sequential-digit telephone dialing. All participants were noninstitutionalized surveillance area residents, >18 years of age. Conditional logistic regression identified the risk factors for invasive GAS infection: in adults 18 to 44 years of age, exposure to one or more children with sore throats (relative risk [RR]=4.93, p=0.02), HIV infection (RR=15.01, p=0.04), and history of injecting drug use (RR=14.71, p=0.003); in adults >45 years of age, number of persons in the home (RR=2.68, p=0.004), diabetes (RR=2.27, p=0.03), cardiac disease (RR=3.24, p=0.006), cancer (RR=3.54, p=0.006), and corticosteroid use (RR=5.18, p=0.03). Thus, host and environmental factors increased the risk for invasive GAS disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Case-Control Studies
  • Child
  • Environmental Exposure
  • Female
  • Health Status
  • Humans
  • Male
  • Middle Aged
  • Population Surveillance*
  • Risk Factors
  • Streptococcal Infections / epidemiology
  • Streptococcal Infections / etiology*
  • Streptococcus pyogenes / isolation & purification*
  • Substance Abuse, Intravenous
  • Surveys and Questionnaires