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Group A Streptococcal Infections in Children
Molla Imaduddin Ahmed1, Rosalind V Saunders2, Srini Bandi1
1Department of Paediatrics, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom.
Insights
Invasive group A streptococcal disease (iGAS) in children presents variedly, with early diagnosis and prompt antibiotic treatment crucial for good outcomes. This study reviewed 57 pediatric iGAS cases, highlighting management and mortality factors.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Microbiology
- Epidemiology of Bacterial Infections
Background:
- Invasive group A streptococcal disease (iGAS) is increasingly recognized in children, associated with severe outcomes including prolonged hospitalization, mortality, and long-term morbidity.
- The rising incidence of iGAS globally necessitates a renewed focus on effective early diagnosis, management, and prevention strategies.
Purpose of the Study:
- To review the diverse clinical presentations of iGAS in pediatric patients.
- To analyze the management strategies and outcomes for children diagnosed with iGAS infections.
Main Methods:
- Retrospective review of medical data for 57 children with confirmed iGAS from sterile site cultures over an 8-year period.
- Analysis of clinical presentations, diagnostic methods, antibiotic treatments (initial and optimized), length of stay, intensive care unit admission, and patient outcomes, including mortality and readmissions.
Main Results:
- The incidence of iGAS was 6-7 cases annually, with a mean hospital stay of 11 days; 21.1% required intensive care.
- Fever was the most common symptom, and pneumonia with or without empyema was the most frequent diagnosis.
- Antibiotic management varied, with ceftriaxone commonly used initially, and 50% later optimized to IV benzylpenicillin; 7% of patients died.
Conclusions:
- The study underscores the varied clinical spectrum of iGAS in children.
- Early and accurate diagnosis, coupled with prompt administration of appropriate antibiotics, is vital for improving patient outcomes and reducing mortality in pediatric iGAS cases.
Background:
Invasive group A streptococcal disease (iGAS) can have varied clinical presentations in children, are responsible for prolonged hospital stays and can cause mortality and long-term morbidity in children. Over the last decade, there has been an increase in the incidence of iGAS infections in the UK and worldwide. This has renewed the focus on early diagnosis, management and prevention of this disease.
Aims And Objectives:
The aim of this study was to review the varied clinical presentations and management of children with iGAS infections.
Methods:
We reviewed the data of children admitted to our tertiary Children's Hospital who had positive isolation of Group A Streptococcus( GAS) from sterile site cultures over the last 8 years. We reviewed their clinical presentations and management including treatment given (antibiotics and duration), outcome and follow up.
Results:
A total of 57 children had iGAS during the study period. The incidence of iGAS was 6-7 cases per year during the study period, except for 2015 when we had 11 cases. The mean length of stay of children admitted with iGAS was 11 days (range 2- 35 days). 21.1% children were admitted to intensive care during their hospital stay. Fever was the most common presenting symptom. Pneumonia with or without empyema was the most common Diagnosis. Initial antibiotic management was varied with ceftriaxone the most commonly used antibiotic in 30% of the cases. 50% of children had their antimicrobial therapy optimised to IV benzylpenicillin after the confirmed isolation of GAS. 7 Children were re-admitted for further treatment and needed a further course of antibiotics. 4 children (7%) died due to iGAS infection.
Conclusion:
Our study highlighted the varied symptomatology and management practices in children with iGAS and showed that early diagnosis and prompt initiation of appropriate antibiotics for iGAS can help in the resolution of symptoms and good outcomes.
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