Clinical Description and Outcomes of Australian Children With Invasive Group A Streptococcal Disease

Area of Science:

• Pediatric Infectious Diseases
• Epidemiology
• Public Health

Background:

• Invasive group A streptococcal disease (iGAS) is a severe infection with a high global mortality rate.
• Early diagnosis of iGAS can be challenging due to variable clinical presentations.
• Limited data exist on the short- and longer-term outcomes of iGAS, particularly in pediatric populations.

Purpose of the Study:

• To evaluate the clinical presentation of invasive group A streptococcal disease in Australian children.
• To assess the management and outcomes of invasive group A streptococcal disease in this cohort.
• To determine the short- and longer-term health consequences for children diagnosed with invasive group A streptococcal disease.

Main Methods:

• A prospective surveillance study was conducted in 7 Australian pediatric hospitals from July 2016 to June 2018.
• Laboratory-confirmed cases of invasive group A streptococcus disease in children (7 days to 16 years) were enrolled.
• Demographic and clinical data were collected, with follow-up at 6 months post-discharge to assess long-term outcomes.

Main Results:

• 181 children were included in the study.
• The most common site of infection was the bloodstream (69.6%), followed by pneumonia (25.4%).
• Severe disease occurred in 40.9% of cases, including streptococcal toxic shock syndrome (14.4%) and intensive care unit admission (39.2%). Five children (2.8%) died. Persisting health problems were reported by 29.3% at discharge and 15.2% at 6 months.

Conclusions:

• Invasive group A streptococcal infection in Australian children is frequently severe.
• The disease carries a significant long-term morbidity burden.
• Strengthened clinical care, surveillance, and prevention strategies are crucial for managing invasive group A streptococcal disease in children.