■侵袭性A组链球菌(iGAS,化脓性链球菌)疾病自2000年以来一直是加拿大的国家法定传染病。这份报告总结了人口统计,emm类型,以及2021年和2022年在加拿大收集的iGAS分离株的抗菌素耐药性。
■加拿大公共卫生署国家微生物实验室与省级和地区公共卫生实验室合作,对侵入性化脓性链球菌进行国家监测。使用疾病控制和预防中心emm测序方案进行Emm分型或从全基因组测序数据中提取。根据临床和实验室标准研究所指南使用Kirby-Bauer圆盘扩散确定抗微生物敏感性,或基于抗性决定子的存在从全基因组测序数据预测。
■总的来说,2021年,加拿大的iGAS疾病发病率为5.56例/10万人口,较2018年的峰值8.6例/10万人口有所下降.2022年共收集了2,630株iGAS分离株,比2021年增加(n=2,179)。特别是,从2022年10月至12月收集的分离株大量增加.在2021年和2022年,最主要的emm类型是emm49,占21.5%(n=468)和16.9%(n=444),分别,自2018年以来,患病率显著上升(p<0.0001)。前一种最普遍的类型,emm1,从2021年的0.5%(n=10)增加到2022年的4.8%(n=125);同样,emm12从2021年的1.0%(n=22)增加到2022年的5.8%(n=151)。这两种类型共占2022年末(10月至12月)收集的分离株的近25%。2021年和2022年的抗菌素耐药率包括:14.9%/14.1%红霉素耐药,4.8%/3.0%克林霉素耐药,和<1%氯霉素抗性。
■在加拿大收集的iGAS分离株的增加是一个重要的公共卫生问题。iGAS的持续监测对于监测不断扩大的emm类型和抗菌素耐药性模式至关重要。
UNASSIGNED: Invasive group A streptococcal (iGAS, Streptococcus pyogenes) disease has been a nationally notifiable disease in Canada since 2000. This report summarizes the demographics, emm types, and antimicrobial resistance of iGAS isolates collected in Canada in 2021 and 2022.
UNASSIGNED: The Public Health Agency of Canada\'s National Microbiology Laboratory collaborates with provincial and territorial public health laboratories to conduct national surveillance of invasive S. pyogenes. Emm typing was performed using the Centers for Disease Control and Prevention emm sequencing protocol or extracted from whole-genome sequencing data. Antimicrobial susceptibilities were determined using Kirby-Bauer disk diffusion according to Clinical and Laboratory Standards Institute guidelines or predicted from whole-genome sequencing data based on the presence of resistance determinants.
UNASSIGNED: Overall, the incidence of iGAS disease in Canada was 5.56 cases per 100,000 population in 2021, decreasing from the peak of 8.6 cases per 100,000 population in 2018. A total of 2,630 iGAS isolates were collected during 2022, representing an increase from 2021 (n=2,179). In particular, there was a large increase in isolates collected from October to December 2022. The most predominant emm type overall in 2021 and 2022 was emm49, at 21.5% (n=468) and 16.9% (n=444), respectively, representing a significant increase in prevalence since 2018 (p<0.0001). The former most prevalent type, emm1, increased from 0.5% (n=10) in 2021 to 4.8% (n=125) in 2022; similarly, emm12 increased from 1.0% (n=22) in 2021 to 5.8% (n=151) in 2022. These two types together accounted for almost 25% of isolates collected in late 2022 (October to December). Antimicrobial resistance rates in 2021 and 2022 included: 14.9%/14.1% erythromycin resistance, 4.8%/3.0% clindamycin resistance, and <1% chloramphenicol resistance.
UNASSIGNED: The increase of iGAS isolates collected in Canada is an important public health concern. Continued surveillance of iGAS is critical to monitor expanding emm types and antimicrobial resistance patterns.