State of the Art of Invasive Group A Streptococcus Infection in Children: A Scoping Review of the Literature with a Focus on Predictors of Invasive Infection

Mariani, Francesco; Gentili, Carolina; Pulcinelli, Valentina; Martino, Laura; Valentini, Piero; Buonsenso, Danilo

doi:10.3390/children10091472

Cited by 3 publications

(8 citation statements)

References 22 publications

(31 reference statements)

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“…6,12 Esta incidencia aumenta en los países en vías de desarrollo, hasta 75 por 100,000, dándose también mayor número de casos de secuelas no supurativas como la cardiopatía reumática. 1,3,4,13,14 Durante los años de la pandemia por SARS-CoV-2 hubo un descenso brusco de estas infecciones. Sin embargo, se está observando un incremento de EISGA en la población pediátrica desde invierno de 2022.…”

Section: Epidemiologíaunclassified

“…Sin embargo, se está observando un incremento de EISGA en la población pediátrica desde invierno de 2022. 13,[15][16][17][18][19] Dado que en Reino Unido las infecciones por SGA son de declaración obligatoria, en noviembre de 2022 se notificó un aumento de 28% de estas patologías. 16 Esto hizo saltar las alarmas por parte de organizaciones como la Organización Mundial de la Salud (OMS), el European Centre for Disease Prevention and Control (ECDC) 17 y la Pan American Health Organization (PAHO).…”

Section: Epidemiologíaunclassified

“…Este aumento de EISGA, especialmente en menores de 10 años, comenzó a notificarse en diferentes países de altos recursos. 13,15,[19][20][21] En la red española PedGAS, esta tendencia de aumento de casos entre noviembre y diciembre de 2022 también se corroboró, junto con un descenso de las mismas en la época de la pandemia SARS-CoV-2 (Figura 1). 22 El hecho de que este aumento de incidencia sea generalizado puede ser multifactorial, relacionado con una menor exposición a los SGA y otras infecciones durante la pandemia por SARS-CoV-2, debido al distanciamiento físico, medidas de barrera como las mascarillas y aumento del lavado de manos, reduciendo la exposición y la sensibilidad del sistema inmunológico, 16,21,23 o la circulación de virus como influenza que puedan facilitar la infección por SGA 24,25 o también a la emergencia y circulación de cepas toxigénicas.…”

Section: Epidemiologíaunclassified

“…Como antecedentes se encuentran la faringoamigdalitis por S. pyogenes, intervenciones quirúrgicas, presencia de soluciones de continuidad, o cuadro de varicela en la semana previa. 5,10,13,17 Sin embargo, la cobertura vacunal frente al virus de varicela zóster (VVZZ) ha hecho que disminuya drásticamente. 6 También se ha visto relación con la infección por influenza A, produciendo predisposición para las EISGA, especialmente neumonía con empiema.…”

Section: Epidemiologíaunclassified

“…Entre las EISGA, la más frecuente es la bacteriemia; otros cuadros son la sepsis, fascitis necrosante, neumonía-empiema, artritis séptica y osteomielitis. 4,5,7,12,13,17,19,24,30,37,[70][71][72] Con menor frecuencia, se han descrito casos de meningitis, infecciones intraabdominales, bursitis, infección relacionada con catéter, endocarditis y pericarditis. 30,37 La fascitis necrosante es una infección profunda del tejido subcutáneo que causa una rápida destrucción de la fascia y la grasa con una gran morbimortalidad.…”

Section: Clínicaunclassified

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Enfermedad pediátrica por estreptococo del grupo A. Revisión narrativa del estado actual

Baeza Céspedes,

Martínez Campos

2024

Revista Latinoamericana De Infectología Pediátrica

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After the SARS-CoV-2 pandemic, we have witnessed an alarm indicating the increase in invasive group A streptococcus disease and SEIP launched a research network (PedGAS-net) to study these infections. On the other hand, given the significant burden of disease caused by GHG, there are initiatives promoted by the WHO for the study and research of vaccines applicable to all populations. Finally, in 2020, a strain with decreased susceptibility to penicillin was described, which would mean the emergence of a new resistance mechanism with important implications. The purpose of this review is to update knowledge of GAS disease.

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Section: Epidemiologíaunclassified

Section: Clínicaunclassified

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Enfermedad pediátrica por estreptococo del grupo A. Revisión narrativa del estado actual

Baeza Céspedes,

Martínez Campos

2024

Revista Latinoamericana De Infectología Pediátrica

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Group A Streptococcus infections in children and adolescents in the post-COVID-19 era: a regional Italian survey

Cinicola,

Sani,

Pulvirenti

et al. 2024

Ital J Pediatr

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Background Despite the worldwide increasing incidence of Group A Streptococcus (GAS) infections reported since December 2022, data on noninvasive GAS (nGAS) infections in the post COVID-19 era are limited. By a self-reported survey performed in an outpatient setting, we investigated the number and clinical features of GAS infections, the diagnostic work-up and the type of treatment utilized. In addition, the rate of influenza vaccination was evaluated. Methods In June 2023 family pediatricians involved in the study sent the survey to parents of patients aged 0–16 years. The survey included questions on GAS infections that occurred from January 1 to May 31, 2023. Results Among 3580 children, 20.3% had a GAS infection (0,8% < 1 year, 16,4% 1–3 years, 42,3% 3–6 years, 26,5% 6–9 years, 11,4%, 9–12 years, and 2,6% 12–16 years). Symptoms reported were sore throat (76.9%), fever (75.2%), tonsillar exudate (25.2%), lymphadenopathy (21.8%), and scarlet fever (14.7%). A single patient was hospitalized due to GAS meningitis. Twenty four percent of children had more than one GAS infection. In this group, frequencies of symptoms reported in the first and in the following infection were similar, except for fever and scarlet fever which were less frequent during relapses. GAS was identified by rapid antigen detection test in 81.0% of children. Eighty-nine per cent of children were treated with antibiotics, mostly amoxicillin/clavulanate (40.4%) and amoxicillin (39.4%). Thirty four percent of children received influenza vaccine. No difference was observed among immunized and not immunized regarding the number and characteristics of GAS infection. Conclusions We reported a certain prevalence of nGAS infections in children, mainly those aged 3–6 years age, who were mostly characterized by a low score of symptoms, and in most of the cases diagnosed and treated using a microbiological test as confirmatory tool. In this new clinical setting, a national study would be useful to reach more significant data for the definition of a correct diagnosis and clinical management of nGAS infections in children. Moreover, it is important to improve flu vaccination campaign and coverage to protect children from coinfections that could worsen the disease and misdiagnose the etiology of pharyngitis.

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Case report: Abscesses in children caused by invasive group A Streptococcus

Guo,

Zhuang,

et al. 2024

Front. Med.

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Streptococcus is one of the common pathogens of suppurative infections. Invasive group A Streptococcus (iGAS) infections often develop from skin or soft tissue infections, and streptococcal toxic shock syndrome is considered the main cause of death in Chinese children with iGAS infectious disease. However, soft tissue infections caused by iGAS infections, especially the formation of abscesses, are relatively rare. A retrospective study was conducted, and pediatric in-patients who were diagnosed with an iGAS infection identified by cultures from normally sterile sites and treated in a tertiary hospital during 2016–2018 were included. A total of 14 patients were identified, which included 10 boys and four girls. The patients had an age range from 3 months to 10 years and were diagnosed with soft tissue infections and a formation of abscesses caused by iGAS infections. The most common sites of infections were the lower limbs. In five patients, the abscess was accompanied by fever, and the local soft tissue showed redness, swelling, tenderness, and an elevated skin temperature. Laboratory findings included an increased white blood cell (WBC) count in 12 patients, an increased C reactive protein (CRP) level in seven patients, and an increased erythrocyte sedimentation rate (ESR) in 10 patients. No patients had an elevated procalcitonin level. For all 14 patients, we performed puncture and drainage of abscesses, and cultured GAS from the drainage fluid. All children also received antibiotic treatment. During 2 months of follow-up, the patients' condition remained stable and no evidence of kidney or heart damage was observed. For pediatric patients with abscesses, early diagnosis, prompt treatment with incision and drainage, and immediate culture of the drainage fluid are important. Upon confirmation of an iGAS infection, β-lactam antibiotics should be given to provide effective treatment, and in some patients with poor therapeutic outcomes, the use of vancomycin as an alternative can achieve the desired results.

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State of the Art of Invasive Group A Streptococcus Infection in Children: A Scoping Review of the Literature with a Focus on Predictors of Invasive Infection

Cited by 3 publications

References 22 publications

Enfermedad pediátrica por estreptococo del grupo A. Revisión narrativa del estado actual

Enfermedad pediátrica por estreptococo del grupo A. Revisión narrativa del estado actual

Group A Streptococcus infections in children and adolescents in the post-COVID-19 era: a regional Italian survey

Case report: Abscesses in children caused by invasive group A Streptococcus

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