Invasive disease due to Streptococcus pyogenes: Changes in incidence and prognostic factors

Suárez-Arrabal, María Carmen; Cámara, Luis Alberto Sánchez; Gómez, María Luisa Navarro; Sebastián, María del Mar Santos; Hernández-Sampelayo, Teresa; Mansilla, Emilia Cercenado; Saavedra-Lozano, Jesús

doi:10.1016/j.anpede.2018.12.007

Cited by 4 publications

(4 citation statements)

References 35 publications

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“…An increment in the frequency of invasive diseases caused by S. pyogenes, including pneumonia, has been reported in several countries. 6,[15][16][17] In a study conducted in France on the epidemiology of community-acquired pleural empyema, the frequency of pneumococcal infection declined from 79.1% in 2009 to 36.4% in 2017 (P < 0.001), with S. pyogenes being the leading cause in the later years of the study period (2015-2017, 45.5%). 4 Because of the stable prevalence of S. aureus CAP, recent updates to guidelines recommend maintaining aminopenicillins as first-line treatment for most cases of CAP, since they remain highly active against S. pyogenes and S. pneumoniae.…”

Section: Discussionmentioning

confidence: 99%

Staphylococcus aureus Community-acquired Pneumonia in Children After 13-Valent Pneumococcal Vaccination (2008–2018): Epidemiology, Clinical Characteristics and Outcomes

Aguilera‐Alonso

Nieto²,

Montojo

et al. 2022

Pediatric Infectious Disease Journal

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Background:The epidemiology of community-acquired pneumonia (CAP) has changed, influenced by sociosanitary conditions and vaccination status. We aimed to analyze the recent epidemiology of bacterial CAP in hospitalized children in a setting with high pneumococcal vaccination coverage and to describe the clinical characteristics of pediatric Staphylococcus aureus CAP. Methods: Children <17 years old hospitalized from 2008 to 2018 with bacterial CAP in 5 tertiary hospitals in Spain were included. Cases with pneumococcal CAP were randomly selected as comparative group following a case-control ratio of 2:1 with S. aureus CAP. Results: A total of 313 bacterial CAP were diagnosed: Streptococcus pneumoniae CAP (n = 236, 75.4%), Streptococcus pyogenes CAP (n = 43, 13.7%) and S. aureus CAP (n = 34, 10.9%). Throughout the study period, the prevalence of S. pyogenes increased (annual percentage change: +16.1% [95% CI: 1.7-32.4], P = 0.031), S. pneumoniae decreased (annual percentage change: -4.4% [95 CI: -8.8 to 0.2], P = 0.057) and S. aureus remained stable. Nine isolates of S. aureus (26.5%) were methicillin-resistant. Seventeen cases (50%) with S. aureus CAP had some pulmonary complication and 21 (61.7%) required intensive care. S. pneumoniae CAP showed a trend toward higher prevalence of pulmonary complications compared with S. aureus CAP (69.1% vs. 50.0%, P = 0.060), including higher frequency of pulmonary necrosis (32.4% vs. 5.9%, P = 0.003). Conclusions:The incidence of S. aureus CAP in children remained stable, whereas the prevalence of pneumococcal CAP decreased and S. pyogenes CAP increased. Patients with S. aureus presented a high frequency of severe outcomes, but a lower risk of pulmonary complications than patients with S. pneumoniae.

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Section: Discussionmentioning

confidence: 99%

Staphylococcus aureus Community-acquired Pneumonia in Children After 13-Valent Pneumococcal Vaccination (2008–2018): Epidemiology, Clinical Characteristics and Outcomes

Aguilera‐Alonso

Nieto²,

Montojo

et al. 2022

Pediatric Infectious Disease Journal

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“…En España y en varios países de nuestro entorno, du- rante el tercer año de pandemia, se ha observado un mayor incremento de la incidencia de Streptococcus pyogenes , sin conocerse bien las causas [ 23 – 26 ]. A principios de diciembre de 2022, el Reino Unido decretó una alerta sobre un aumento extraordinario de las infecciones por Streptococcus pyogenes en los meses precedentes, con un incremento de infecciones invasivas (iGAS por sus siglas en inglés) en niños menores de 10 años [ 23 , 27 ].…”

Section: Discussionunclassified

Increase in severe acute respiratory infections in children during the last phase of the COVID-19 pandemic

Bermúdez-Barrezueta,

Brezmes Raposo,

Benito Gutiérrez

et al. 2023

Rev Esp Quimioter

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Objective. The COVID-19 pandemic has caused a variation in the circulation of respiratory pathogens. Our aim was to analyze the epidemiology of severe acute respiratory infections (SARI) in children during 3 years of the COVID-19 pandemic, in comparison with a previous period. Patients and Methods. An observational study was conducted in a tertiary hospital in Spain, which analyzed the frequency and characteristics of patients admitted for SARI in the Pediatric Intensive Care Unit (PICU) during the COVID-19 pandemic (1 March 2020 to 28 February 2023), compared to pre-pandemic period (1 March 2017 to 29 February 2020). Results. A total of 268 patients were included (59.6% males). The median age was 9.6 months (IQR 1.7 – 37). In the pre-pandemic period, there were 126 admissions with an average of 42 admissions/year. During the pandemic, there were 142 admissions, observing a significant reduction in admissions in the first year (12 admissions/year), in contrast to 82 admissions during the third year, which represented an increase of 95% compared to the average of admissions/year in pre-pandemic. In addition, in the last year there was evidence of an increase in viral coinfections in relation to pre-pandemic period (54.9% vs 39.7%; p=0.032). There were no differences in length of hospital stay or PICU stay. Conclusions. During the last year, coinciding with low rates of hospitalization for COVID in Spain, we observed a notable increase in admissions to the PICU for SARI. Probably, the prolonged period of low exposure to pathogens due to the measures adopted during the pandemic might have caused a decrease in population immunity with a rise in severe respiratory infections.

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“…Since the 1980s, there has been a steady rise in invasive group A Streptococcus disease (iGASD) infections, both in adults and children, including infections with a severe clinical course (9,10) . In Europe, the incidence of iGASD ranges between 0.4 and 4.8 cases per 100,000 individuals per year, with mortality rates in children estimated to vary from 0 to 14% (11) . The risk factors for iGASD include the male sex, late pregnancy (past 30 weeks), and the time period of 4 weeks postpartum.…”

Section: Invasive Infectionsmentioning

confidence: 99%

Invasive Streptococcus pyogenes infection – a retrospective clinical analysis of 6 cases

Grunert¹,

Malik²,

Lewandowska³

et al. 2021

Pediatr Med Rodz

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In recent years, there has been a rise in the number of invasive infections caused by Streptococcus pyogenes. The reasons for the observed increased prevalence of the disease are not entirely clear. The present study describes the cases of 6 children hospitalised over a course of one year with a diagnosis of invasive infection due to this pathogen. Three patients were diagnosed with acute post-streptococcal glomerulonephritis and pneumonia (complicated by pleural empyema in 1 patient). Two patients had erysipelas (including one case of recurrent erysipelas), and 1 patient was found to have an abscess in the border area between the femur and soft tissues. The study analyses the clinical course of infection, and highlights the importance of diagnostic tests, particularly the antistreptolysin O titre test, in confirming the infection triggered by Streptococcus pyogenes.

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Invasive disease due to Streptococcus pyogenes: Changes in incidence and prognostic factors

Cited by 4 publications

References 35 publications

Staphylococcus aureus Community-acquired Pneumonia in Children After 13-Valent Pneumococcal Vaccination (2008–2018): Epidemiology, Clinical Characteristics and Outcomes

Staphylococcus aureus Community-acquired Pneumonia in Children After 13-Valent Pneumococcal Vaccination (2008–2018): Epidemiology, Clinical Characteristics and Outcomes

Increase in severe acute respiratory infections in children during the last phase of the COVID-19 pandemic

Invasive Streptococcus pyogenes infection – a retrospective clinical analysis of 6 cases

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