Epidemiological features of invasive and noninvasive group A streptococcal disease in the Netherlands, 1992–1996

  • B. VlaminckxEmail author
  • W. van Pelt
  • L. Schouls
  • A. van Silfhout
  • C. Elzenaar
  • E. Mascini
  • J. Verhoef
  • J. Schellekens


A prospective, nationwide, laboratory-based surveillance of invasive group A streptococcal infections was conducted in the Netherlands from 1992 through 1996. Clinical and demographic data were obtained and all isolates were T/M typed. All noninvasive group A streptococcal isolates were registered from 1994 through 1996. A total of 880 patients with invasive streptococcal disease were identified. The annual incidence was found to be 2.2 per 100,000. Predominant M types were M1 (21%), M3 (11%), M6 (5%), M12 (5%), and M28 (8%). Particular age and M-type distributions were observed in different clinical entities. The case-fatality rate was 18% overall, but it reached 59% among cases of toxic shock-like syndrome. Older age, necrotizing fasciitis, sepsis without focus, pneumonia, infection with type M1 or M3 strains, and underlying cardiopulmonary disease were associated with fatality. A total of 10,105 patients with noninvasive group A streptococcal disease were registered. These patients differed significantly from patients with invasive disease with regard to age distribution and primary foci of infection.


Necrotizing Fasciitis Invasive Isolate Streptococcal Disease Puerperal Sepsis Noninvasive Group 
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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • B. Vlaminckx
    • 1
    Email author
  • W. van Pelt
    • 2
  • L. Schouls
    • 2
  • A. van Silfhout
    • 2
  • C. Elzenaar
    • 2
  • E. Mascini
    • 1
  • J. Verhoef
    • 1
  • J. Schellekens
    • 2
  1. 1.Eijkman Winkler Institute for Medical Microbiology, Infectious Diseases and InflammationUniversity Medical Center UtrechtUtrechtThe Netherlands
  2. 2.National Institute of Public Health and the Environment (RIVM)BilthovenThe Netherlands

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