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[Invasive Streptococcus pyogenes diseases 2005-2013: Pediatric Hospital Pereira Rossell Uruguay]
Introduction:
Streptococcus pyogenes infection causes a wide spectrum of clinical manifestations. Invasive disease (ID) is defined by the isolation of the microorganism from sterile sites.
Objective:
To analyze the clinical, epidemiological and molecular characteristics of ID by S.pyogenes in children hospitalized at Pediatric Hospital Pereira Rossell, from January 2005 to January 2013.
Materials And Methods:
A descriptive retrospective study was done in cases with isolation of S.pyogenes from sterile sites. Epidemiological variables, disease characteristics, laboratory parameters, treatment regimen received, hospitalization days and clinical outcome were analyzed. The presence of 4 genes encoding for virulence factors and chromosome profile studied by pulsed-field electrophoresis were done in the isolated strains.
Results:
A total of 42 cases (rate: 4.6 out of 10,000 admissions) were detected, from which 32 were analyzed. Average age was 44.7 months (14/32 < 2 years of age). In 5 cases, the portal of entry was identified. Clinical presentations were: osteoarticular infections (n = 15), shock (n = 6), skin and soft-tissue infections (n = 5), pneumonia (n = 3) and bacteremias (n = 3). Twenty cases required surgical procedures and 13 required intensive care admission. Average hospital stay was 17 days and one patient died. Molecular studies were performed in five strains; 4 different toxin profiles and pulsotypes were identified.
Discussion:
The incidence of ID at our hospital is similar to other series in the region. A better knowledge of clinical presentation and its relation with molecular characteristics represents a challenge.
Insights
Invasive Streptococcus pyogenes disease in children is characterized by diverse clinical presentations, including osteoarticular infections and shock. Understanding these presentations and their molecular basis is crucial for effective management.
Area of Science:
- Pediatric Infectious Diseases
- Microbiology
- Epidemiology
Context:
- Streptococcus pyogenes can cause severe invasive disease (ID) in children, requiring hospitalization.
- Understanding the clinical, epidemiological, and molecular aspects of invasive S. pyogenes infections is essential for public health.
- This study focuses on pediatric cases of invasive S. pyogenes at a specific hospital over an eight-year period.
Purpose:
- To analyze the clinical, epidemiological, and molecular characteristics of invasive S. pyogenes disease in hospitalized children.
- To identify common clinical presentations, risk factors, and outcomes.
- To investigate the molecular profiles of S. pyogenes strains using virulence gene analysis and pulsed-field gel electrophoresis.
Summary:
- A retrospective study identified 42 cases of invasive S. pyogenes, with 32 analyzed. The average age was 44.7 months, with 14 children under two years old.
- Common clinical manifestations included osteoarticular infections (15 cases), shock (6 cases), and skin/soft-tissue infections (5 cases). Twenty cases required surgery, and 13 needed intensive care.
- Molecular analysis of five strains revealed four distinct toxin profiles and pulsotypes, highlighting potential strain variability.
Impact:
- The incidence of invasive S. pyogenes disease at the hospital is comparable to regional data.
- Findings underscore the need for enhanced understanding of clinical presentations and their correlation with molecular characteristics.
- This research contributes to the knowledge base for managing invasive S. pyogenes infections in pediatric populations.