Group A streptococcal disease in paediatric inpatients: a European perspective
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 Se...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Other Authors: | |
| Format: | Journal article |
| Language: | English |
| Published: |
Springer Nature
2022
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| _version_ | 1797111622474399744 |
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| author | Boeddha, NP Atkins, L de Groot, R Driessen, G Hazelzet, J Zenz, W Carrol, ED Anderson, ST Martinon-Torres, F Agyeman, PKA Galassini, R Herberg, J Levin, M Schlapbach, LJ Emonts, M Pollard, AJ |
| author2 | EUCLIDS consortium |
| author_facet | EUCLIDS consortium Boeddha, NP Atkins, L de Groot, R Driessen, G Hazelzet, J Zenz, W Carrol, ED Anderson, ST Martinon-Torres, F Agyeman, PKA Galassini, R Herberg, J Levin, M Schlapbach, LJ Emonts, M Pollard, AJ |
| author_sort | Boeddha, NP |
| collection | OXFORD |
| description | 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).
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Conclusion:</strong> 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. |
| first_indexed | 2024-03-07T08:11:30Z |
| format | Journal article |
| id | oxford-uuid:b2dc372c-0caa-4740-ac93-b19822b69fb8 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T08:11:30Z |
| publishDate | 2022 |
| publisher | Springer Nature |
| record_format | dspace |
| spelling | oxford-uuid:b2dc372c-0caa-4740-ac93-b19822b69fb82023-11-30T12:14:49ZGroup A streptococcal disease in paediatric inpatients: a European perspectiveJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:b2dc372c-0caa-4740-ac93-b19822b69fb8EnglishSymplectic ElementsSpringer Nature2022Boeddha, NPAtkins, Lde Groot, RDriessen, GHazelzet, JZenz, WCarrol, EDAnderson, STMartinon-Torres, FAgyeman, PKAGalassini, RHerberg, JLevin, MSchlapbach, LJEmonts, MPollard, AJEUCLIDS consortiumGroup 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). <br><strong> Conclusion:</strong> 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. |
| spellingShingle | Boeddha, NP Atkins, L de Groot, R Driessen, G Hazelzet, J Zenz, W Carrol, ED Anderson, ST Martinon-Torres, F Agyeman, PKA Galassini, R Herberg, J Levin, M Schlapbach, LJ Emonts, M Pollard, AJ Group A streptococcal disease in paediatric inpatients: a European perspective |
| title | Group A streptococcal disease in paediatric inpatients: a European perspective |
| title_full | Group A streptococcal disease in paediatric inpatients: a European perspective |
| title_fullStr | Group A streptococcal disease in paediatric inpatients: a European perspective |
| title_full_unstemmed | Group A streptococcal disease in paediatric inpatients: a European perspective |
| title_short | Group A streptococcal disease in paediatric inpatients: a European perspective |
| title_sort | group a streptococcal disease in paediatric inpatients a european perspective |
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