Poster Presentation Lancefield International Symposium for Streptococci and Streptococcal Diseases 2025

Descriptive analysis of incidence, hospital acquisition and health inequalities in invasive group C and G streptococcal infections England, 2016 to 2023 (#123)

Rebecca L Guy 1 , Jamie Rudman 1 , Karen Broughton 1 , Kartyk Moganeradj 1 , Mariyam Mirfenderesky 1 , Colin S Brown 1 , Theresa Lamagni 1
  1. UK Health Security Agency, London, LONDON, United Kingdom

Introduction

The detailed epidemiology of invasive Group C and Group G Streptococcal (iGCS/GGS) in England has not previously been investigated. Given longitudinal increases in these pathogens,[1] we assessed patterns of disease to prioritise development of healthcare and public health interventions.

Methods

Invasive (sterile-site) GCS/GGS data between 01/01/2016 and 31/12/2023 for England were extracted from UKHSA’s national laboratory reporting database,[2] then augmented through linkage to capture hospital acquisition,[3] ethnicity,[4] and socioeconomic deprivation.[5][6] Hospital acquired infection (HAI) was defined as iGCS/GGS specimen taken ≥3-days after hospital admission. Residential clusters were defined as ≥2 cases within 90-days from the same residential postcode.

Results

Between 2016 and 2023, 24,711 iGCS/GGS were reported in England; median age: 77yrs (IQR: 65-86yrs), 54.2% (n=13,395) male). Annual rates of iGCS/GGS increased 25% (4.6 to 5.8/100,000 population) between 2016 and 2022, peaking in 2019 (6.2/100,000).

iGCS/GGS was more frequently identified in patients living in the most-deprived quintile of the country (22.5%; n=5551), with 0.2% (n=160) cases having no fixed abode. A total of 518 residential clusters were identified (median 2 per-cluster; maximum 6 cases), with a median of 41-days between cases (IQR: 21-63-days). iGCS/GGS annual incidence was 4-fold higher in people of white versus black ethnicity.

HAI was identified in 4% cases (n=941), increasing from 3.9% in 2016 to 4.9% in 2022.

Discussion      

This first in-depth national study on iGCS/GGS in England and highlights differences amongst patients with reported iGCS/GGS, with variation by ethnicity. Further investigation of household risk and clustering is needed to identify opportunities for prevention.

 

  1. UK Health Security Agency. Laboratory surveillance of streptococcal bacteraemia in England: 2023 update [Internet]. London; 2024. Available from: https://www.gov.uk/government/publications/pyogenic-and-non-pyogenic-streptococcal-bacteraemia-annual-data-from-voluntary-surveillance
  2. UK Health Security Agency. Laboratory reporting to UKHSA: a guide for diagnostic laboratories [Internet]. London; 2023. Available from: https://assets.publishing.service.gov.uk/media/647749ce5f7bb700127fa25a/UKHSA_Laboratory_reporting_guidelines_May_2023.pdf
  3. NHS England. Hospital Episode Statistics (HES) [Internet]. 2023. Available from: https://digital.nhs.uk/data-and-information/data-tools-and-services/dataservices/hospital-episode-statistics
  4. Office for Health Improvement & Disparities. Method for assigning ethnic group in the COVID-19 Health Inequalities Monitoring for England (CHIME) tool [Internet]. 2022. Available from: https://www.gov.uk/government/statistics/covid-19-health-inequalities-monitoring-in-england-tool-chime/method-for-assigning-ethnic-group-in-the-covid-19-health-inequalities-monitoring-for-england-chime-tool
  5. ONS. Population by Index of Multiple Deprivation (IMD), England, 2001 to 2019 [Internet]. 2020. Available from: https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/adhocs/12386populationbyindexofmultipledeprivationimdengland2001to2019
  6. Ministry of Housing Communities & Local Government (MHCLG). English indices of deprivation 2019 [Internet]. 2019. Available from: https://www.gov.uk/government/statistics/english-indices-of-deprivation-2019