Oral Presentation 20th Lancefield International Symposium on Streptococci and Streptococcal Diseases 2017

The epidemiology of invasive and non-invasive group A streptococcus in Cape Town, South Africa: The AFROStrep Registry (#83)

Dylan Barth 1 , Preneshni Naicker 2 , Kélin Engel 1 , Babu Muhamed 1 , Bongani Mayosi 1 , Mark Engel 1
  1. University of Cape Town, Cape Town, WESTERN CAPE, South Africa
  2. National Health Laboratory Service , Cape Town

BACKGROUND Group A β-haemolytic streptococcus(GAS), is responsible for a wide range of diseases which include pharyngitis, Rheumatic Fever and Rheumatic Heart Disease. Primordial prevention efforts include a vaccine based on thirty variants of the M protein product of the emm gene. We report the distribution of invasive (iGAS) and non-invasive(non-iGAS)isolates obtained from the National Health Laboratory Services.  In addition, we wished to compare emm subtypes of GAS isolates against those incorporated in the putative vaccine.METHODS This hospital-based study forms part of the AFROStrep study, designed to collect clinical, microbiological and molecular data on GAS in Africa. iGAS was defined as GAS isolated from a sterile site, while non-iGAS was isolated from a non-sterile site. We performed DNA extraction and PCR on our isolates. Sequencing is currently underway so as to determine potential vaccine coverage of the 30-valent vaccine formulation.RESULTS Between March 2016 to February 2017, 440 GAS isolates were recovered from patients aged 3 months – 89 years. iGAS infection comprised 40%(n=176), majority being male, (65%). Clinical presentation of cases included bacteraemia, septic arthritis and necrotising fasciitis, while common sites of isolation were from pus swabs, abscesses, aspirates, blood and deep tissue. Sequencing results are pending and will be presented at the conference.CONCLUSION This study, the first of its kind in South Africa confirms that GAS is a significant cause of disease, frequently isolated from patients with invasive disease in Cape Town. Increased awareness amongst healthcare personnel and vaccine efforts are urgently warranted. We anticipate our sequencing results will further contribute to informing vaccine initiatives.