Invasive Group A Streptococcal Infections in Children

Tapiainen, Terhi; Launonen, Saana; Renko, Marjo; Saxén, Harri; Salo, Eeva; Korppi, Matti; Kainulainen, Leena; Heiskanen‐Kosma, Tarja; Lindholm, Laura; Vuopio, Jaana; Huotari, Tiina; Rusanen, Jarmo; Uhari, Matti

doi:10.1097/inf.0000000000000945

Cited by 48 publications

(63 citation statements)

References 19 publications

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“…GAS infections have been increasing, along with resistance to macrolide antibiotics but not to penicillin. A rise in GAS has been reported in Scotland in 2015 and Finland between 1990 and 2010 …”

Section: Introductionmentioning

confidence: 99%

“…A rise in GAS has been reported in Scotland in 2015 and Finland between 1990 and 2010. 2,3 Scottish Intercollegiate Guideline Network (SIGN) guidelines state tonsillectomy should be performed if patients are suffering from severe recurrent tonsillitis-see Box 1. Tonsillectomy is one of the most commonly performed surgical procedures in the UK, accounting for 20% of all operations performed by otolaryngologists.…”

Section: Introductionmentioning

confidence: 99%

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A 20‐year observational cohort of a 5 million patient population—Tonsillectomy rates in the context of two national policy changes

Douglas

Altmyer

Cottom

et al. 2018

Clinical Otolaryngology

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Aim (a) To report national trends for tonsillectomy, tonsillitis, peritonsillar abscess and deep neck space infection in secondary care. (b) To report national trends in sore throat consultations in primary care. (c) To report national trends in antibiotic prescribing in both primary and secondary care between 2011 and 2015. Design Retrospective nationwide cohort study. Data requested from Information Statistics Department (ISD) Scotland for tonsillectomy, tonsillitis admissions, peritonsillar abscess admissions and deep neck space infection (DNSI) admissions in Scotland, between 1993/94 and 2015/16. Data for antibiotic prescriptions in general practice and hospital admissions between 2011 and 2015. Setting Scottish ENT departments and GP practices. Participants Scottish patients who underwent tonsillectomy or were admitted to hospital with tonsillitis, peritonsillar abscess or deep neck space infection. Scottish patients that attended their GP with tonsillitis. Results Tonsillectomy rates between 1993/94 and 2015/16 decreased by 48% (P < 0.001). Over the same time period, there has been a corresponding 136% increase in tonsillitis admission (P < 0.001) and a 167% increase in peritonsillar abscess admissions, (P < 0.001). Between 1996/97 and 2015/16, there was a 500% increase in deep neck space abscesses (P < 0.001). Conclusion There has been a significant decrease in tonsillectomy rates over the past two decades. Over the same time period, there has been a significant increase in admissions to secondary care with tonsillitis, peritonsillar abscess and deep neck space infection. These changes have happened in the context of two separate national policies being introduced—Scottish Intercollegiate Guideline Network (SIGN) guidelines for management of sore throat and the Scottish Reduction in Antibiotic Prescribing.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A 20‐year observational cohort of a 5 million patient population—Tonsillectomy rates in the context of two national policy changes

Douglas

Altmyer

Cottom

et al. 2018

Clinical Otolaryngology

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“…The incidence of iSPI varies greatly among different countries and regions, and among different populations in the same region. [4][5][6][7][8] However, the overall incidence rate has increased in recent years. 4,9,10 China lacks a monitoring system for iGAS; there are very few studies on iGAS or iSPI and even fewer studies in newborns.…”

Section: Discussionmentioning

confidence: 99%

Analysis of 11 Cases of Neonatal Invasive Streptococcus pyogenes Infection

Xie

Chen

et al. 2020

Journal of Pediatric Infectious Diseases

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Objective This study aimed to improve the understanding of clinical characteristics of neonatal invasive Streptococcus pyogenes infection (iSPI). Methods A retrospective study was performed to analyze the clinical and laboratory aspects of culture-confirmed neonatal iSPI cases during 2010 to 2017. Results Eleven cases of neonatal iSPI were confirmed. The ages ranged from 2 hours to 26 days. Ten cases had positive blood culture results and one had positive cerebrospinal fluid culture for S. pyogenes. Seven patients had fever and seven had identified focal infection, including six skin and soft tissue infections and one case of pneumonia. All of the S. pyogenes strains were sensitive to penicillin, cefotaxime, and vancomycin, and nine were resistant to clindamycin and erythromycin. Six patients received penicillin or cephalosporin monotherapy. Three patients received meropenem plus vancomycin initially, and then two of them were switched to penicillin and one to vancomycin after pathogen identification. Two cases were treated with vancomycin monotherapy. All cases were discharged after being cured or showing improvement. Conclusion Skin and soft tissue infection is a common manifestation of neonatal iSPI. Streptococcus pyogenes strains are highly sensitive to β-lactams, which should be used as the first-choice treatment.

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“…Our results are similar to these findings from complicated cases: [21] the most common pathogens found were S. pyogenes (19%), S. pneumoniae (14%), and P. aeruginosa (11%), whereas only 2% had H. influenzae and none had M. catarrhalis. Within 15 years in Finland, invasive S. pyogenes infections have tripled in children [27] . In our study population, the total number of infections doubled from the first to the second five-year period, but there was no change in the proportions of pathogens (Figure 1).…”

Section: Discussionmentioning

confidence: 99%

Severe Acute Otitis Media and Acute Mastoiditis in Adults

Hongisto

Jero

Markkola³

et al. 2016

Int Adv Otol

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OBJECTIVE:To evaluate and compare clinical and microbiological findings in adults hospitalized for acute otitis media (AOM) or mastoid infections (acute or latent). MATERIALS and METHODS:We retrospectively reviewed the medical records of all adults (≥17 years old) hospitalized (between 2003 and 2012) at a tertiary referral center for acute mastoid infections or AOM not responding to outpatient medical treatment. RESULTS:Of the 160 patients in the study sample, 19% had an infection caused by S. pyogenes, 14% by S. pneumoniae, and 11% by P. aeruginosa. AOM was the most common infection (38%), whereas 33% had acute mastoiditis (AM), 18% had latent mastoiditis (LM), and 13% AM of a chronically infected ear (AMc). In contrast to the other infections, P. aeruginosa (30%) and S. aureus (25%) were most common in AMc. Otorrhea (83%), tympanic membrane perforation (57%), and hearing problems (83%) were common in S. pyogenes infections. Patients with S. pneumoniae had longer lengths of hospitalization than those with other bacterial infections (7 vs. 4 days). Otorrhea (94%) and retroauricular symptoms were more common in P. aeruginosa infections. Hearing symptoms were common (67%) but fever (32%) and retroauricular symptoms were uncommon in AOM. Fever (44%) and mastoid tenderness (65%) were common in AM. Patients with LM underwent the most mastoidectomies (54%). Prior medical conditions, retroauricular symptoms, otorrhea (90%), and post-infection problems were common in AMc. CONCLUSION:The bacteriological etiology of hospitalized AOM more closely resembled those of LM and AM than that of AMc. Adults hospitalized for AOM or AM required fewer mastoidectomies than those hospitalized for LM or AMc.

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Invasive Group A Streptococcal Infections in Children

Abstract: The incidence rate of pediatric iGAS infections tripled during our study. The increase was not, however, the result of a change in the strain types causing iGAS. Varicella immunization would likely have prevented a significant number of the cases.

Cited by 48 publications

References 19 publications

A 20‐year observational cohort of a 5 million patient population—Tonsillectomy rates in the context of two national policy changes

A 20‐year observational cohort of a 5 million patient population—Tonsillectomy rates in the context of two national policy changes

Analysis of 11 Cases of Neonatal Invasive Streptococcus pyogenes Infection

Severe Acute Otitis Media and Acute Mastoiditis in Adults

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