Group A streptococcal disease in paediatric inpatients: a European perspective.

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Boeddha, Navin P, Atkins, Lucy, de Groot, Ronald, Driessen, Gertjan, Hazelzet, Jan, Zenz, Werner, Carrol, Enitan D ORCID: 0000-0001-8357-7726, Anderson, Suzanne T, Martinon-Torres, Federico, Agyeman, Philipp KA et al (show 5 more authors) , Galassini, Rachel, Herberg, Jethro, Levin, Michael, Schlapbach, Luregn J and Emonts, Marieke (2022) Group A streptococcal disease in paediatric inpatients: a European perspective. European journal of pediatrics, 182 (2). pp. 697-706. ISSN 0340-6199, 1432-1076

Text 20221113-GAS DISEASE IN PAEDIATRIC INPATIENTS_EJPE_revision_clean.author accepted. docx.docx - Author Accepted Manuscript Download (184kB)

Abstract

Group A streptococcal (GAS) disease shows increasing incidence worldwide. We characterised children admitted with GAS infection to European hospitals and studied risk factors for severity and disability. This is a prospective, multicentre, cohort study (embedded in EUCLIDS and the Swiss Pediatric Sepsis Study) including 320 children, aged 1 month to 18 years, admitted with GAS infection to 41 hospitals in 6 European countries from 2012 to 2016. Demographic, clinical, microbiological and outcome data were collected. A total of 195 (61%) patients had sepsis. Two hundred thirty-six (74%) patients had GAS detected from a normally sterile site. The most common infection sites were the lower respiratory tract (LRTI) (22%), skin and soft tissue (SSTI) (23%) and bone and joint (19%). Compared to patients not admitted to PICU, patients admitted to PICU more commonly had LRTI (39 vs 8%), infection without a focus (22 vs 8%) and intracranial infection (9 vs 3%); less commonly had SSTI and bone and joint infections (p < 0.001); and were younger (median 40 (IQR 21-83) vs 56 (IQR 36-85) months, p = 0.01). Six PICU patients (2%) died. Sequelae at discharge from hospital were largely limited to patients admitted to PICU (29 vs 3%, p < 0.001; 12% overall) and included neurodisability, amputation, skin grafts, hearing loss and need for surgery. More patients were recruited in winter and spring (p < 0.001).<h4>Conclusion</h4>In an era of observed marked reduction in vaccine-preventable infections, GAS infection requiring hospital admission is still associated with significant severe disease in younger children, and short- and long-term morbidity. Further advances are required in the prevention and early recognition of GAS disease.<h4>What is known</h4>• Despite temporal and geographical variability, there is an increase of incidence of infection with group A streptococci. However, data on the epidemiology of group A streptococcal infections in European children is limited.<h4>What is new</h4>• In a large, prospective cohort of children with community-acquired bacterial infection requiring hospitalisation in Europe, GAS was the most frequent pathogen, with 12% disability at discharge, and 2% mortality in patients with GAS infection. • In children with GAS sepsis, IVIG was used in only 4.6% of patients and clindamycin in 29% of patients.

Item Type:	Article
Uncontrolled Keywords:	Streptococcus pyogenes, Child, Hospital, Outcome
Divisions:	Faculty of Health & Life Sciences Faculty of Health & Life Sciences > Inst. Infection, Vet & Ecological Sciences
Depositing User:	Symplectic Admin
Date Deposited:	06 Feb 2023 08:57
Last Modified:	01 Mar 2026 11:56
DOI:	10.1007/s00431-022-04718-y
Related Websites:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3166580
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