The prevalence of asymptomatic carriage of Streptococcus pyogenes: a systematic literature review and meta-analysis
Summary
Since the beginning of 2022, an upsurge in the number of invasive group A streptococcal (GAS) infections has been noticed. To be able to guide new studies on asymptomatic carriage of GAS, extensive knowledge on rates before the COVID-19 pandemic is important. This review aimed to create an overview of current knowledge on the prevalence of asymptomatic GAS carriage across different age groups, continents and sample sites/methods used for the detection of GAS.In total, 27 studies including 26,537 participants were identified. The pooled prevalence of asymptomatic GAS carriage was 6% (95%CI: 4-9%). Stratified meta-analyses showed that the pooled prevalence significantly differed between subgroups based on source population, sample site and GAS detection method used in the included studies. The prevalence of asymptomatic GAS carriage was found to be 6%. The prevalence significantly differed across studies using different source populations, GAS detection sample sites and methods. Future research should focus on comparing carriage rates before and after the COVID-19 pandemic, to further investigate the cause of the recent upsurge in (invasive) GAS infections.