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Invasive Streptococcus pyogenes infections in children
N Cimolai1, C Trombley, R J Adderley
1Department of Pathology, British Columbia's Children's Hospital, Vancouver.
Insights
Invasive Streptococcus pyogenes infections, particularly orthopedic cases, increased in children from 1984-1990. An M1T1 epidemic strain coincided with rising scarlet fever and strep throat cases.
Area of Science:
- Pediatric Infectious Diseases
- Epidemiology
- Microbiology
Background:
- Group A Streptococcus (Streptococcus pyogenes) is a significant pathogen in pediatric populations.
- Invasive infections, though less common, can lead to severe morbidity and mortality.
- Understanding trends in invasive S. pyogenes infections is crucial for public health surveillance.
Purpose of the Study:
- To investigate the epidemiology and clinical characteristics of invasive S. pyogenes infections in children over a 7-year period.
- To identify trends in the incidence of invasive S. pyogenes infections.
- To correlate these trends with the prevalence of non-invasive S. pyogenes infections.
Main Methods:
- Retrospective review of pediatric patient data from 1984 to 1990.
- Analysis of infection frequency per 10,000 admissions and outpatients.
- Strain typing of identified S. pyogenes isolates.
Main Results:
- A notable increase in invasive S. pyogenes infections was observed, rising from 0 to 11.81 per 10,000 admissions.
- Orthopedic infections constituted a substantial proportion (48%) of invasive cases.
- An epidemic M1T1 strain of S. pyogenes was identified.
- Concurrent increases in scarlet fever and streptococcal pharyngitis ('strep throat') were documented.
Conclusions:
- The study highlights a significant rise in invasive S. pyogenes infections among pediatric patients during the study period.
- The emergence of an M1T1 epidemic strain and increased non-invasive S. pyogenes infections likely contributed to this trend.
- These findings underscore the importance of ongoing surveillance for invasive bacterial infections.
Abstract:
We investigated the epidemiology and clinical features of invasive S. pyogenes infection in a pediatric population over a 7-year period (1984-90) by retrospective review. An increasing frequency in invasive infections had occurred (0-11.81/10,000 admissions). A large proportion (48%) of these were orthopedic infections. An epidemic strain was typed as M1T1. This increase appears to have occurred in the context of an overall increase in S. pyogenes infections ("scarlet fever" 1.47-11.22/10,000 outpatients; "strep throat" 4.41-46.54/10,000 outpatients).