Group a Streptococcal Disease in Paediatric Inpatients: a European Perspective

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Boeddha, Navin, Atkins, Lucy, De Groot, Ronald, Driessen, Gertjan, Hazelzet, Jan, Zenz, Werner, Carrol, Enitan ORCID: 0000-0001-8357-7726, Anderson, Suzanne, Martinon-Torres, Federico, Agyeman, Philipp et al (show 5 more authors) , Galassini, Rachel, Herberg, Jethro, Levin, Michael, Schlapbach, Luregn ORCID: 0000-0003-2281-2598 and Emonts, Marieke (2022) Group a Streptococcal Disease in Paediatric Inpatients: a European Perspective [Preprint]

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Abstract

<h4>Purpose: </h4> 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.  <h4>Methods: </h4>: Prospective, multicenter, 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 2012-2016. Demographic, clinical, microbiological and outcome data were collected.  <h4>Results: </h4>: 195 (61%) patients had sepsis. 236 (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>Conclusions: </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.

Item Type:	Preprint
Uncontrolled Keywords:	32 Biomedical and Clinical Sciences, 3202 Clinical Sciences, Infectious Diseases, Patient Safety, Pediatric Research Initiative, Sepsis, Clinical Research, Prevention, Hematology, Infection, 3 Good Health and Well Being
Divisions:	Faculty of Health & Life Sciences Faculty of Health & Life Sciences > Inst. Infection, Vet & Ecological Sciences
Depositing User:	Symplectic Admin
Date Deposited:	10 Jun 2024 09:22
Last Modified:	26 Feb 2026 22:12
DOI:	10.21203/rs.3.rs-2170182/v1
Related Websites:	Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3182100
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