Streptococcus anginosus group infections in hospitalised children and young people

Area of Science:

• Microbiology
• Infectious Diseases
• Pediatrics

Background:

• The Streptococcus anginosus group (SAG) comprises three bacterial species known for causing pyogenic infections.
• While SAG infections are documented in adults, pediatric cases are less understood.
• This study focuses on characterizing SAG infections in children at an Australian center.

Purpose of the Study:

• To characterize the clinical features and outcomes of Streptococcus anginosus group infections in hospitalized children.
• To identify species-specific differences in infection sites and associated risks.
• To analyze trends in SAG-associated intra-abdominal infections over time.

Main Methods:

• Retrospective review of medical records for hospitalized patients aged 18 years or younger with positive SAG cultures from January 2009 to December 2019.
• Data collection included patient demographics, infection sites, treatments received (antibiotics, surgery), and outcomes (readmission, further surgery).
• Species identification of SAG was analyzed, with a focus on trends since 2011.

Main Results:

• Two hundred children with SAG infections were identified; 62% were male, with a median age of 12 years.
• The most common infection sites were the abdomen (39%), soft tissues (36%), and head and neck (21%).
• Streptococcus intermedius was more frequently associated with head and neck infections, while S. constellatus and S. anginosus were linked to intra-abdominal infections. A significant increase in SAG-associated intra-abdominal infections was observed since 2015.

Conclusions:

• Streptococcus anginosus group infections in children manifest at diverse anatomical locations.
• Despite antibiotic and surgical interventions, nearly a quarter of pediatric patients require re-hospitalization.
• Species-specific predilections for infection sites highlight the importance of accurate identification and targeted management.