Cardiopulmonary morbidity of streptococcal infections in a <scp>PICU</scp>

Hon, Kam‐Lun Ellis; Fu, Antony; Leung, Ting Fan; Poon, Terence Chuen Wai; Cheung, Waiman; Fong, Chor Yiu; Ho, Yee Ting Christina; Lee, Tsui Yin Jamie; Ng, Tam Man; Yu, Wai Ling; Cheung, K.Y.; Lee, Vivian; Ip, Margaret

doi:10.1111/crj.12103

Cited by 11 publications

(5 citation statements)

References 46 publications

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“…The efficacy of the PCV 13 against serotype 3 infection is low. 6,7 Despite immunization program and effective treatment, serotype 3 IPD remains a significant problem, prompting the need for surveillance of serotype prevalence and vaccine efficacy, with implications for future vaccine development.…”

Section: To the Editorsmentioning

confidence: 99%

Serotype 3 Pneumococcal-associated Hemolytic Uremic Syndrome and Kidney Transplant

Hon¹,

Hui²,

Leung³

et al. 2022

Pediatric Infectious Disease Journal

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Section: To the Editorsmentioning

confidence: 99%

Serotype 3 Pneumococcal-associated Hemolytic Uremic Syndrome and Kidney Transplant

Hon¹,

Hui²,

Leung³

et al. 2022

Pediatric Infectious Disease Journal

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“…Patients present with fever, rash, hypotension, and organ failure, and it can be lifethreatening. 9 Endotoxins produced by S pyogenes are associated with disease invasiveness. Streptococcal pyrogenic exotoxin A and streptococcal superantigen, are two of the superantigens that stimulate T-cell response and induce cytokinemediated inflammatory reactions, thereby leading to shock and organ dysfunction.…”

Section: Streptococcal Toxic Shock Syndromementioning

confidence: 99%

Group A Streptococcus disease in Hong Kong children: an overview

2018

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Group A β-haemolytic Streptococcus or Streptococcus pyogenes is a gram-positive coccus that tends to grow in chains. Streptococcus pyogenes is the cause of many important human diseases, ranging from pharyngitis and mild superficial skin infections to lifethreatening systemic diseases. Infections typically begin in the throat or skin. Mild Streptococcus pyogenes infections include pharyngitis (strep throat) and localised skin infections (impetigo). Erysipelas and cellulitis are characterised by multiplication and lateral spread of Streptococcus pyogenes in deep layers of the skin. Streptococcus pyogenes invasion and fascial involvement can lead to necrotising fasciitis, a life-threatening condition. Scarlet fever is characterised by a sandpaper-like rash in children with fever and is caused by a streptococcal toxin. Severe infections that lead to septicaemia or toxic shock syndrome are associated with high mortality. Autoimmune reactions cause characteristic syndromes such as rheumatic fever and nephritis. Epidemiology, disease presentation, diagnosis, and

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“…Children are prone to infections, especially towards these two group streptococci (5, 10-13). Severe infections, with life-threatening complications as a result of these two streptococci are albeit uncommon but associated with high mortality and morbidity, and often necessitate intensive care support [ 8 , 16 ]. However, epidemiology of these severe infections in pediatric intensive care settings is seldom reported.…”

Section: Introductionmentioning

confidence: 99%

Severe Group A and Group B Streptococcus Diseases at a Pediatric ICU: Are they Still Sensitive to the Penicillins?

Hon

Chow

Cheung

et al. 2020

CCP

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Background: Group A β-hemolytic streptococcus (GAS) and Group B streptococcus (GBS) are two common pathogens that are associated with many diseases in children. Severe infections as a result of these two streptococci are albeit uncommon but associated with high mortality and morbidity, and often necessitate intensive care support. This paper aims to review mortality and morbidity severe infection associated with GAS and GBS isolations at a Pediatric Intensive Care Unit (PICU). Methods: All children admitted to PICU of a teaching hospital between October 2002 and May 2018 with laboratory-proven GAS and GBS isolations were included. Results: There were 19 patients (0.7% PICU admissions) with streptococcal isolations (GAS, n=11 and GBS, n=8). Comparing to GAS, GBS affected infants were younger (median age 0.13 versus 5.47 years, 95% CI, 1.7-8.5, p=0.0003), and cerebrospinal fluids more likely positive (p = 0.0181). All GAS and GBS were sensitive to penicillin (CLSI: MICs 0.06 – 2.0 μg/mL), with majority of GAS sensitive to clindamycin and erythromycin, and half of the GBS resistant to clindamycin and erythromycin. Co-infections were prevalent, but viruses were only isolated with GAS (p=0.024). Isolation of GAS and GBS was associated with nearly 40% mortality and high rates of mechanical ventilation and inotropic supports. All non-survivors had high mortality (PIM2) and sepsis scores. Conclusions: Severe GAS and GBS are rare but associated with high mortality and rates of mechanical ventilation and inotropic supports in PICU. The streptococci are invariably sensitive to penicillin. The high PIM2 and Sepsis scores suggest that prompt recognition of sepsis and timely judicious institution of antibiotics and intensive care support may be life-saving for these devastating infections.

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Cardiopulmonary morbidity of streptococcal infections in a PICU

Cited by 11 publications

References 46 publications

Serotype 3 Pneumococcal-associated Hemolytic Uremic Syndrome and Kidney Transplant

Serotype 3 Pneumococcal-associated Hemolytic Uremic Syndrome and Kidney Transplant

Group A Streptococcus disease in Hong Kong children: an overview

Severe Group A and Group B Streptococcus Diseases at a Pediatric ICU: Are they Still Sensitive to the Penicillins?

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