Intro: The epidemiology of invasive group A Streptococcus (iGAS) has been previously documented in Alberta, Canada; however, the role coinfections with respiratory viral infections (VRIs) play with associated emm types remains unclear. Here, we aimed to (1) evaluate the number of iGAS-VRI coinfections from 2018 to 2024, (2) identify the emm types found in iGAS-VRI coinfections, and (3) analyze the temporal trends of coinfection within iGAS cases.
Methods: iGAS and VRI data recorded between 1 January 2018 and 31 December 2024 were obtained from the Public Health Laboratory, and patient results were reviewed. An iGAS-VRI coinfection was considered to be a VRI case ± 28 days of an iGAS case. Using R statistical testing, Fisher’s exact test was conducted to analyze emm type and age, while a Cochran Armitage trend test was used to assess coinfection trends.
Results: Of 2126 iGAS cases, 254 coinfections (11.9%) were observed, with emm1, 12, 49, 74, and 81 having the highest prevalence. For individual viral analysis, iGAS-SARS-CoV2 coinfections were most prevalent, followed by entero/rhino virus (ERV) and influenza. In addition, ages 4 and under were disproportionally affected by coinfection, while coinfection cases were disproportionally associated with emm1. While the overall number of coinfection cases has increased, its proportion relative to iGAS infection is trending negatively.
Conclusion: We observed that iGAS-VRI coinfections in Alberta occurred in 11.9% of iGAS cases. Statistical analysis revealed that emm1 and ages under 4 were disproportionally represented in coinfection cases. Also, the occurrence of coinfections within iGAS infections are trending negatively.
Author Contributions
S.N. compiled and analyzed the data and wrote the first draft of the abstract and presented the poster. A.T. performed the statistical analysis. G.J.T. conceptualized the study, and worked with S.N. on subsequent drafts of abstract. All authors have read and agreed to the published version of the manuscript.
Funding
This research received no external funding.
Institutional Review Board Statement
University of Alberta REB approval Pro00140378.
Informed Consent Statement
Not applicable.
Data Availability Statement
The data presented in this study are available upon request from the corresponding author.
Conflicts of Interest
The authors declare no conflict of interest.
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