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Abstract

Invasive Group A Streptococcus and Respiratory Viral Coinfections in Alberta, Canada, from 2018 to 2024 †

by
Skyler Ngo
,
Alexa Thompson
and
Gregory J. Tyrrell
*
Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB T6G 2J2, Canada
*
Author to whom correspondence should be addressed.
†
Presented at the 22nd Lancefield International Symposium on Streptococci and Streptococcal Diseases, Brisbane, Australia, 1–5 June 2025.
Proceedings 2025, 124(1), 4; https://doi.org/10.3390/proceedings2025124004
Published: 6 August 2025
(This article belongs to the Proceedings of The 22nd Lancefield International Symposium on Streptococci and Streptococcal Diseases (LISSSD 2025))
Versions Notes

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.
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.

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MDPI and ACS Style

Ngo, S.; Thompson, A.; Tyrrell, G.J. Invasive Group A Streptococcus and Respiratory Viral Coinfections in Alberta, Canada, from 2018 to 2024. Proceedings 2025, 124, 4. https://doi.org/10.3390/proceedings2025124004

AMA Style

Ngo S, Thompson A, Tyrrell GJ. Invasive Group A Streptococcus and Respiratory Viral Coinfections in Alberta, Canada, from 2018 to 2024. Proceedings. 2025; 124(1):4. https://doi.org/10.3390/proceedings2025124004

Chicago/Turabian Style

Ngo, Skyler, Alexa Thompson, and Gregory J. Tyrrell. 2025. "Invasive Group A Streptococcus and Respiratory Viral Coinfections in Alberta, Canada, from 2018 to 2024" Proceedings 124, no. 1: 4. https://doi.org/10.3390/proceedings2025124004

APA Style

Ngo, S., Thompson, A., & Tyrrell, G. J. (2025). Invasive Group A Streptococcus and Respiratory Viral Coinfections in Alberta, Canada, from 2018 to 2024. Proceedings, 124(1), 4. https://doi.org/10.3390/proceedings2025124004

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