Epidemiology and clinical features of Streptococcus pyogenes bloodstream infections in children in Madrid, Spain

Cobo-Vázquez, Elvira; Aguilera‐Alonso, David; Carbayo, Tania; Figueroa-Ospina, Lucía M; Sanz-Santaeufemia, Francisco José; Baquero‐Artigao, Fernando; Vázquez-Ordoñez, Carmen; Carrasco-Colom, Jaime; Blázquez‐Gamero, Daniel; Jiménez-Montero, Beatriz; Grasa-Lozano, Carlos; Cilleruelo, María José; Álvarez, A.; Comín-Cabrera, Cristina; Penin, María; Cercenado, Emilia; Valle, Rut Del; Roa, Miguel Ángel; Diego, Irene García-De; Calvo, Cristina; Saavedra-Lozano, Jesús

doi:10.1007/s00431-023-04967-5

Cited by 14 publications

(19 citation statements)

References 16 publications

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“…This finding was generally attributed to the impact of NPIs, although it was not definitively clarified whether the greater role was played by the reduction of interpersonal transmission of the pathogen or by the suppression of the activity of several seasonal respiratory viruses. Infections by influenza viruses, RSV, and hMPV favor pneumococcal colonization and are frequently complicated by S. pneumoniae superinfection [ 24 , 27 , 88 , 89 , 90 , 91 ]. Results of the study by Danino et al significantly contribute to solving the problem [ 92 ].…”

Section: Sars-cov-2 Circulation and Incidence Of Bacterial Infectionsmentioning

confidence: 99%

“…The COVID-19 pandemic has been accompanied by significant variations in the global incidence of diseases due to the most common non-SARS-CoV-2 respiratory viruses [ 25 , 26 ] and some bacteria [ 27 , 28 ]. The incidence of respiratory infections was initially reduced, although with differences between infecting agents.…”

Section: Introductionmentioning

confidence: 99%

“…A rapid return to traditional levels was evidenced in some cases. In other cases, low circulation persisted for several months and a return to pre-pandemic levels was reached only after three pandemic years [ 25 , 26 , 27 , 28 ]. Several factors could explain these findings, including the implementation of the various NPIs and the duration of their use.…”

Section: Introductionmentioning

confidence: 99%

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Epidemiology of Respiratory Infections during the COVID-19 Pandemic

Principi

Autore

Ramundo

et al. 2023

Viruses

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To face the COVID-19 outbreak, a wide range of non-pharmaceutical interventions (NPIs) aimed at limiting the spread of the virus in communities, such as mask-wearing, hand hygiene, social distancing, travel restrictions, and school closures, were introduced in most countries. Thereafter, a significant reduction of new asymptomatic and symptomatic COVID-19 cases occurred, although there were differences between countries according to the type and duration of the NPIs. In addition, the COVID-19 pandemic has been accompanied by significant variations in the global incidence of diseases due to the most common non-SARS-CoV-2 respiratory viruses and some bacteria. In this narrative review, the epidemiology of the most common non-SARS-CoV-2 respiratory infections during the COVID-19 pandemic is detailed. Moreover, factors that could have had a role in modifying the traditional circulation of respiratory pathogens are discussed. A literature analysis shows that NPIs were the most important cause of the general reduction in the incidence of influenza and respiratory syncytial virus infection in the first year of the pandemic, although the different sensitivity of each virus to NPIs, the type and duration of measures used, as well as the interference among viruses may have played a role in modulating viral circulation. Reasons for the increase in the incidences of Streptococcus pneumoniae and group A Streptococcus infections seem strictly linked to immunity debt and the role played by NPIs in reducing viral infections and limiting bacterial superimposed infections. These results highlight the importance of NPIs during pandemics, the need to monitor the circulation of infectious agents that cause diseases similar to those caused by pandemic agents, and the need to make efforts to improve coverage with available vaccines.

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Section: Sars-cov-2 Circulation and Incidence Of Bacterial Infectionsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Epidemiology of Respiratory Infections during the COVID-19 Pandemic

Principi

Autore

Ramundo

et al. 2023

Viruses

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“…Interestingly, in the clustered cases reported by the Spanish multicenter network for analyzing iGAS in Spain (Ped-GAS-net) in late 2022, there was a shift towards a lower age and presentation with pneumonia and pleural effusion as well as a significant increase in ICU admissions of iGAS compared to prepandemic years [ 6 , 17 ]. The overall mortality in this study was 1.8% [ 6 ].…”

Section: Clinical Manifestations Of Igasmentioning

confidence: 99%

Group A Streptococcus invasive infection in children: Epidemiologic changes and implications

Ramos Amador,

Berzosa Sánchez,

Illán Ramos

2023

Rev Esp Quimioter

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Group A Streptococcus (GAS) can cause a broad array of clinical manifestations and complications. Recently, in post COVID-19 postpandemic months, there has been an increased incidence and severity of invasive infections in the pediatric age group in Spain and other European countries with high morbidity, affecting mostly to young children, associated with seasonal peaks in incidence of viral respiratory pathogens. The increased in incidence and severity has not been associated with predominant GAS strains, but rather to the lack of immunity to both GAS and common viral respiratory infections due to isolation measures to prevent COVID-19. Due to the nonspecific initial clinical manifestations a high index of suspicion is necessary in order to initiate a prompt medical and surgical treatment when necessary to improve the outcome. Prevention strategies are needed as well as continuous microbiological surveillance of iGAS strains.

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“…Streptococcus pyogenes , or group A Streptococcus (GAS), is one of the most frequent bacterial pathogens in the pediatric population, producing a wide array of mild and invasive diseases ( 1 – 3 ). S. pyogenes has a great pathogenic potential due to its capacity to carry multiple virulence factors ( 4 , 5 ), including the surface M protein encoded by the emm gene.…”

Section: Introductionmentioning

confidence: 99%

Clinical, microbiological, and molecular characterization of pediatric invasive infections by Streptococcus pyogenes in Spain in a context of global outbreak

Ramírez de Arellano,

Saavedra-Lozano,

Villalón

et al. 2024

mSphere

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In December 2022, an alert was published in the UK and other European countries reporting an unusual increase in the incidence of Streptococcus pyogenes infections. Our aim was to describe the clinical, microbiological, and molecular characteristics of group A Streptococcus invasive infections (iGAS) in children prospectively recruited in Spain (September 2022–March 2023), and compare invasive strains with strains causing mild infections. One hundred thirty isolates of S. pyogenes causing infection (102 iGAS and 28 mild infections) were included in the microbiological study: emm typing, antimicrobial susceptibility testing, and sequencing for core genome multilocus sequence typing (cgMLST), resistome, and virulome analysis. Clinical data were available from 93 cases and 21 controls. Pneumonia was the most frequent clinical syndrome (41/93; 44.1%), followed by deep tissue abscesses (23/93; 24.7%), and osteoarticular infections (11/93; 11.8%). Forty-six of 93 cases (49.5%) required admission to the pediatric intensive care unit. iGAS isolates mainly belonged to emm 1 and emm 12; emm 12 predominated in 2022 but was surpassed by emm 1 in 2023. Spread of M1 UK sublineage (28/64 M1 isolates) was communicated for the first time in Spain, but it did not replace the still predominant sublineage M1 global (36/64). Furthermore, a difference in emm types compared with the mild cases was observed with predominance of emm 1, but also important representativeness of emm 12 and emm 89 isolates. Pneumonia, the most frequent and severe iGAS diagnosed, was associated with the spe A gene, while the ssa superantigen was associated with milder cases. iGAS isolates were mainly susceptible to antimicrobials. cgMLST showed five major clusters: ST28-ST1357/ emm 1, ST36-ST425/ emm 12, ST242/ emm 12.37, ST39/ emm 4, and ST101-ST1295/ emm 89 isolates. IMPORTANCE Group A Streptococcus (GAS) is a common bacterial pathogen in the pediatric population. In the last months of 2022, an unusual increase in GAS infections was detected in various countries. Certain strains were overrepresented, although the cause of this raise is not clear. In Spain, a significant increase in mild and severe cases was also observed; this study evaluates the clinical characteristics and the strains involved in both scenarios. Our study showed that the increase in incidence did not correlate with an increase in resistance or with an emm types shift. However, there seemed to be a rise in severity, partly related to a greater rate of pneumonia cases. These findings suggest a general increase in iGAS that highlights the need for surveillance. The introduction of whole genome sequencing in the diagnosis and surveillance of iGAS may improve the understanding of antibiotic resistance, virulence, and clones, facilitating its control and personalized treatment.

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Epidemiology and clinical features of Streptococcus pyogenes bloodstream infections in children in Madrid, Spain

Cited by 14 publications

References 16 publications

Epidemiology of Respiratory Infections during the COVID-19 Pandemic

Epidemiology of Respiratory Infections during the COVID-19 Pandemic

Group A Streptococcus invasive infection in children: Epidemiologic changes and implications

Clinical, microbiological, and molecular characterization of pediatric invasive infections by Streptococcus pyogenes in Spain in a context of global outbreak

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