Group A streptococcal infections in children

Abstract

The group A streptococcus causes the widest range of disease in humans of all bacterial pathogens. Group A streptococcal diseases are more common in children than adults with diseases ranging from pharyngitis and impetigo to invasive infections and the post-streptococcal sequelae--acute rheumatic fever and acute post-streptococcal glomerulonephritis. The global burden of severe group A streptococcal disease is concentrated largely in developing countries and Indigenous populations such as Aboriginal Australians. Control of group A streptococcal disease is poor in these settings and the need for a vaccine has been argued. With an ever-increasing understanding of the group A streptococcus at a molecular level, new and sophisticated vaccines are currently in human trials and the next decade holds exciting prospects for curbing group A streptococcal diseases.

Disease Manifestations and Pathogenic Mechanisms of Group A Streptococcus

“…APSGN rates are highest in children in less developed countries, with incidence rates as high as 94.3/1,000 being reported in the Northern Territory of Australia (76). Unlike ARF, APSGN tends to occur in outbreaks associated with "nephritogenic" strains of GAS (e.g., emm types 1, 4, 12, 49, 55, 57, and 60) and contributing risk factors such as crowding, poor hygiene, and poverty (75)(76)(77). With proper supportive care, long-term renal damage as a result of APSGN is rare.…”

Streptococcus pyogenes upper respiratory infection and atopic conditions other than asthma: a retrospective cohort study

“…7 Known risk factors for S. pyogenes upper respiratory tract infections include exposure to cigarette smoke, low birth weight, and low socioeconomic status. 5,8,9 Recently, we found that children with asthma have an increased risk of S. pyogenes infection compared with those without asthma. 10 At present it is unknown whether atopic dermatitis or allergic rhinitis poses an increased risk of S. pyogenes upper respiratory tract infections.…”

“…3 A recent report suggests that S. pyogenes infection was the third most common organism causing pulmonary bacterial co-infection in patients with fatal cases of 2009 novel H1N1 influenza. 4 Each year, 600 million new cases of S. pyogenes pharyngitis, 500,000 deaths worldwide, 5 and an estimated 8,950-11,500 cases of invasive S. pyogenes infections occur in the USA resulting in 1,050-1,850 deaths. 6 …”

Focus on systemic lupus erythematosus in Indigenous Australians: towards a better understanding of autoimmune diseases

“…ARF is said to follow GAS pharyngitis but not skin infection, however IA children have a low incidence of GAS pharyngitis and low rates of upper respiratory tract GAS carriage but a high incidence of pyoderma. 49,50 In high-incidence ARF populations, including IA in the Northern Territory and Maori people in New Zealand, the M-serotypes of GAS are absent. Thus, the role of other serotypes, likely to be involved in skin infection such as GAS impetigo, may be crucial in ARF pathogenesis in these populations (reviewed in Steer et al 51 ).…”