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Perineal group A streptococcal disease in a pediatric practice
N P Mogielnicki1, J D Schwartzman, J A Elliott
1Department of Pediatrics and Community and Family Medicine, Dartmouth Medical School, Lebanon, New Hampshire, USA. nancy.p.mogielnicki@hitchcock.org
Pediatrics
|August 2, 2000
Summary
Group A Streptococcus (GAS) can cause common perineal infections in children, with specific strains showing a tendency for these sites. Further research is needed to understand the infection mechanisms.
Area of Science:
- Pediatric infectious diseases
- Microbiology
- Epidemiology
Background:
- Group A beta-hemolytic streptococci (GAS) are a common cause of pharyngitis.
- An increase in perineal GAS infections was observed in a pediatric practice.
Purpose of the Study:
- To determine the incidence of perineal GAS disease.
- To characterize the clinical, epidemiological, and microbiological features of these infections in children.
Main Methods:
- Retrospective data collection on culture-confirmed cases from 1997.
- Analysis of GAS isolates using T typing, emm gene analysis, and pulsed-field gel electrophoresis (PFGE).
- Comparison with GAS pharyngitis isolates.
Main Results:
- Twenty-three cases of perineal GAS disease were identified (13 perianal, 8 vulvovaginal).
- Infections occurred primarily in 5-year-olds, with seasonal peaks in late winter/early spring.
- A specific GAS type (T 28 emm 28) predominated in perineal infections (82%), unlike pharyngeal isolates.
Conclusions:
- Perineal GAS infections are a potentially common diagnosis in pediatric settings.
- Specific GAS strains may exhibit tropism for perineal tissues.
- The mechanism of perineal GAS infection requires further investigation.