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Thean LJ, Jenney A, Engelman D, Romani L, Wand H, Mani J, Paka J, Cua T, Taole S, Soqo V, Sahukhan A, Kama M, Tuicakau M, Kado J, Carvalho N, Whitfeld M, Kaldor J, Steer AC. Prospective surveillance for invasive Staphylococcus aureus and group A Streptococcus infections in a setting with high community burden of scabies and impetigo. Int J Infect Dis 2021; 108:333-339. [PMID: 34022330 DOI: 10.1016/j.ijid.2021.05.041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 05/12/2021] [Accepted: 05/15/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Invasive Staphylococcus aureus (iSA) and group A Streptococcus (iGAS) impose significant health burdens globally. Both bacteria commonly cause skin and soft tissue infections (SSTIs), which can result in invasive disease. Understanding of the incidence of iSA and iGAS remains limited in settings with a high SSTI burden. METHODS Prospective surveillance for admissions with iSA or iGAS was conducted at the referral hospital in Fiji's Northern Division over 48 weeks between July 2018 and June 2019. RESULTS There were 55 admissions for iSA and 15 admissions for iGAS (incidence 45.2 and 12.3 per 100,000 person-years, respectively). The highest incidence was found in patients aged ≥65 years (59.6 per 100,000 person-years for iSA and iGAS). The incidence of iSA was higher in indigenous Fijians (iTaukei) (71.1 per 100,000 person-years) compared with other ethnicities (incidence rate ratio 9.7, 95% confidence interval 3.5-36.9). SSTIs were found in the majority of cases of iSA (75%) and iGAS (53.3%). Thirteen of the 14 iGAS strains isolated belonged to emm cluster D (n = 5) or E (n = 8). The case fatality rate was high for both iSA (10.9%) and iGAS (33.3%). CONCLUSIONS The incidence of iSA and iGAS in Fiji is very high. SSTIs are common clinical foci for both iSA and iGAS. Both iSA and iGAS carry a substantial risk of death. Improved control strategies are needed to reduce the burden of iSA and iGAS in Fiji.
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Affiliation(s)
- Li Jun Thean
- Tropical Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.
| | - Adam Jenney
- College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji
| | - Daniel Engelman
- Tropical Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia; Melbourne Children's Global Health, Melbourne Children's Campus, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Lucia Romani
- Kirby Institute, University of New South Wales, Kensington, New South Wales, Australia
| | - Handan Wand
- Kirby Institute, University of New South Wales, Kensington, New South Wales, Australia
| | - Jyotishna Mani
- Tropical Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Jessica Paka
- Tropical Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Tuliana Cua
- Tropical Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Sera Taole
- Tropical Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Vika Soqo
- Ministry of Health and Medical Services, Suva, Fiji
| | | | - Mike Kama
- Ministry of Health and Medical Services, Suva, Fiji
| | | | - Joseph Kado
- Ministry of Health and Medical Services, Suva, Fiji; Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Natalie Carvalho
- School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Margot Whitfeld
- Department of Dermatology, St. Vincent's Hospital, Darlinghurst, New South Wales, Australia; School of Medicine, University of New South Wales, Kensington, New South Wales, Australia
| | - John Kaldor
- Kirby Institute, University of New South Wales, Kensington, New South Wales, Australia
| | - Andrew C Steer
- Tropical Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia; Melbourne Children's Global Health, Melbourne Children's Campus, The Royal Children's Hospital, Parkville, Victoria, Australia
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Getahun S A, Limaono J, Ligaitukana R, Cabenatabua O, Soqo V, Diege R, Mua M. Ovarian abscess caused by Salmonella enterica serovar Typhi: a case report. J Med Case Rep 2019; 13:303. [PMID: 31551082 PMCID: PMC6760102 DOI: 10.1186/s13256-019-2229-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 08/13/2019] [Indexed: 11/10/2022] Open
Abstract
Background Typhoid fever is a human-specific disease caused by a bacterium, Salmonella enterica subspecies enterica serovar Typhi. It is transmitted through ingestion of contaminated food or water. It is mostly diagnosed by blood culture. Salmonella Typhi usually manifests as a febrile illness with bacteremia after initial entry through the gastrointestinal route, but it can occasionally cause significant disease in extraintestinal sites. We report a case of a girl in Fiji with a right ovarian abscess infected by Salmonella Typhi. Case presentation A 14-year-old iTaukei (indigenous Fijian) girl presented to our hospital with abdominal pain of 1 month’s duration. Two days prior to her admission, she developed high-grade fever and nausea and had one episode of vomiting. On presentation, she appeared unwell; she was tachycardic (116 beats per minute) and febrile (38.8 °C). Her abdominal examination revealed generalized tenderness. Other examination findings were normal. The provisional diagnosis of abdominal sepsis led to an emergency laparotomy during which an enlarged right ovary was found to be spontaneously discharging pus. The ovary was incised and drained, and the patient was commenced on intravenous ceftriaxone 1 g twice daily, cloxacillin 1 g four times daily, and metronidazole 500 mg three times daily. She recovered promptly and was discharged to home on the sixth postoperative day. The purulent material from the ovary grew Salmonella Typhi. Conclusion Extraintestinal infections caused by Salmonella Typhi are rare but can cause severe and life-threatening disease. Our patient had a prolonged history of abdominal pain and was found to have a ruptured right ovarian abscess due to Salmonella Typhi. Ovarian abscesses in girls who are not sexually active are not associated with pelvic inflammatory disease and suggest local or hematogenous spread. This case report may increase health workers awareness to include common and endemic infections in the differential diagnosis of unusual clinical presentations to help the initiation of appropriate investigation and management as quickly as possible.
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Affiliation(s)
- Aneley Getahun S
- School of Public Health, College of Medicine Nursing and Health Science, Fiji National University, Suva, Fiji. .,The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC 3000, Australia.
| | - Josese Limaono
- Labasa Hospital, Ministry of Health and Medical Services, Labasa, Fiji
| | - Raween Ligaitukana
- Northern Health Services, Ministry of Health and Medical Services, Labasa, Fiji
| | - Orisi Cabenatabua
- Labasa Hospital, Ministry of Health and Medical Services, Labasa, Fiji
| | - Vika Soqo
- Labasa Hospital, Ministry of Health and Medical Services, Labasa, Fiji
| | - Raape Diege
- Labasa Hospital, Ministry of Health and Medical Services, Labasa, Fiji
| | - Mikaele Mua
- Labasa Hospital, Ministry of Health and Medical Services, Labasa, Fiji
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