TY - JOUR
T1 - Surveillance of invasive beta-haemolytic streptococci in Denmark, 2012 to 2023
T2 - A nationwide study
AU - Christiansen, Cecilie Hviid
AU - Søgaard, Kirstine Kobberøe
AU - Dam-Dalgeir, Gertrud
AU - Dessau, Ram B
AU - Dzajic, Esad
AU - Jensen, Christian Salgård
AU - Lützen, Lisbeth
AU - Pedersen, Michael
AU - Skovgaard, Sissel
AU - Sydenham, Thomas Vognbjerg
AU - Hoffmann, Steen
AU - Nielsen, Hans Linde
N1 - Copyright © 2025 The Author(s). Published by Elsevier Ltd.. All rights reserved.
PY - 2025/8
Y1 - 2025/8
N2 - OBJECTIVES: To analyse trends in incidence, seasonality, and antimicrobial resistance of invasive beta-haemolytic streptococci (iBHS) in Denmark from 2012 to 2023.METHODS: Nationwide laboratory surveillance included submission of invasive isolates of Lancefield group A, B, C, and G streptococci from blood, cerebrospinal fluid, and other sterile sites to the National Reference Laboratory. Incidence rates (IRs) per 100,000 were calculated. Seasonality was analysed using Poisson regression, and antimicrobial susceptibility was determined by EUCAST disc diffusion.RESULTS: In total, 9,470 iBHS cases were identified. Annual IRs increased from 2.6 to 9.4 for iGAS, 2.5 to 4.9 for iGBS, 1.4 to 4.8 for iGCS, and 3.1 to 8.5 for iGGS. iGAS exhibited marked seasonality, peaking in February and troughing in September (peak-to-trough ratio 3.2). Incidence declined during the COVID-19 pandemic but rebounded in 2023. No seasonality was observed for iGBS, iGCS, or iGGS. Incidences were highest in males and older adults, except iGBS, which showed a bimodal distribution. Recurrent infections occurred in 5.4% of cases, predominantly with iGGS and iGCS. All isolates were penicillin susceptible, but erythromycin and clindamycin resistance increased in iGBS and iGGS.CONCLUSIONS: The rising incidence of iBHS, particularly iGAS resurgence and increasing resistance, highlights the need for continued surveillance.
AB - OBJECTIVES: To analyse trends in incidence, seasonality, and antimicrobial resistance of invasive beta-haemolytic streptococci (iBHS) in Denmark from 2012 to 2023.METHODS: Nationwide laboratory surveillance included submission of invasive isolates of Lancefield group A, B, C, and G streptococci from blood, cerebrospinal fluid, and other sterile sites to the National Reference Laboratory. Incidence rates (IRs) per 100,000 were calculated. Seasonality was analysed using Poisson regression, and antimicrobial susceptibility was determined by EUCAST disc diffusion.RESULTS: In total, 9,470 iBHS cases were identified. Annual IRs increased from 2.6 to 9.4 for iGAS, 2.5 to 4.9 for iGBS, 1.4 to 4.8 for iGCS, and 3.1 to 8.5 for iGGS. iGAS exhibited marked seasonality, peaking in February and troughing in September (peak-to-trough ratio 3.2). Incidence declined during the COVID-19 pandemic but rebounded in 2023. No seasonality was observed for iGBS, iGCS, or iGGS. Incidences were highest in males and older adults, except iGBS, which showed a bimodal distribution. Recurrent infections occurred in 5.4% of cases, predominantly with iGGS and iGCS. All isolates were penicillin susceptible, but erythromycin and clindamycin resistance increased in iGBS and iGGS.CONCLUSIONS: The rising incidence of iBHS, particularly iGAS resurgence and increasing resistance, highlights the need for continued surveillance.
U2 - 10.1016/j.jinf.2025.106559
DO - 10.1016/j.jinf.2025.106559
M3 - Article
C2 - 40714117
SN - 0163-4453
VL - 91
JO - Journal of Infection
JF - Journal of Infection
IS - 2
M1 - 106559
ER -