Abstract
Background
Group A streptococcus bacteraemia is an uncommon but serious infection with a UK incidence of 3/100,000 person years and a mortality of 20%. Surveillance, managed in England by the Health Protection Agency (HPA), is used to monitor disease epidemiology, to generate outcome data, and to alert public health professionals of national and local changes in incidence.
Surveillence risks generating potentially misleading data if reporting is biased or variable, but the completeness of the HPA laboratory generated surveillence dataset (Co-Surv) is not routinely verified.
Aims
To determine the completeness of reporting of GAS bacteraemia by laboratories in the South West of England over the period 2006 to 2011, to quantify changes in reporting behaviour over time, and to assess reporting bias in terms of 30 day mortality.
Method. The proportion of GAS bacteraemias identified by ten microbiology laboratories in England that were reported to the HPA over a five year period was determined by comparing laboratory and HPA datasets. The 30 day all cause mortality of those reported was compared to those not reported.
Results. Reporting to the HPA was poor with 133 (34%) of 391isolates not being reported. There was considerable variation between laboratories, with reporting ranging from 13% to 100%. There was a non significant trend towards increased mortality in the cases reported to the HPA compared to those not reported (p=0.17, fisher’s exact test). Excluding laboratories who did not provide data over the whole time period, reporting improved from 46% in 2006 – 2007 financial year, to 76% in 2010-2011.
Conclusions. Overall laboratory reporting of GAS bacteraemias from ten participating laboratories in England was poor and varied with location and over time. Given that the electronic mechanism used to report to the HPA is common to many reported pathogens, it is likely that this finding is not restricted to GAS bacteraemia.
Group A streptococcus bacteraemia is an uncommon but serious infection with a UK incidence of 3/100,000 person years and a mortality of 20%. Surveillance, managed in England by the Health Protection Agency (HPA), is used to monitor disease epidemiology, to generate outcome data, and to alert public health professionals of national and local changes in incidence.
Surveillence risks generating potentially misleading data if reporting is biased or variable, but the completeness of the HPA laboratory generated surveillence dataset (Co-Surv) is not routinely verified.
Aims
To determine the completeness of reporting of GAS bacteraemia by laboratories in the South West of England over the period 2006 to 2011, to quantify changes in reporting behaviour over time, and to assess reporting bias in terms of 30 day mortality.
Method. The proportion of GAS bacteraemias identified by ten microbiology laboratories in England that were reported to the HPA over a five year period was determined by comparing laboratory and HPA datasets. The 30 day all cause mortality of those reported was compared to those not reported.
Results. Reporting to the HPA was poor with 133 (34%) of 391isolates not being reported. There was considerable variation between laboratories, with reporting ranging from 13% to 100%. There was a non significant trend towards increased mortality in the cases reported to the HPA compared to those not reported (p=0.17, fisher’s exact test). Excluding laboratories who did not provide data over the whole time period, reporting improved from 46% in 2006 – 2007 financial year, to 76% in 2010-2011.
Conclusions. Overall laboratory reporting of GAS bacteraemias from ten participating laboratories in England was poor and varied with location and over time. Given that the electronic mechanism used to report to the HPA is common to many reported pathogens, it is likely that this finding is not restricted to GAS bacteraemia.
| Original language | English |
|---|---|
| Publication status | Accepted/In press - 19 Nov 2012 |
| Event | Federation of Infection Societies 2012 - Liverpool, United Kingdom Duration: 19 Nov 2012 → 22 Nov 2012 |
Conference
| Conference | Federation of Infection Societies 2012 |
|---|---|
| Country/Territory | United Kingdom |
| City | Liverpool |
| Period | 19/11/12 → 22/11/12 |
Keywords
- Group A streptococcus
- Surveillence