Related Experiment Video
Updated: Aug 19, 2025
A Murine Model of Group B Streptococcus Vaginal Colonization
Published on: November 16, 2016
Group A streptococcal disease in paediatric inpatients: a European perspective
Navin P Boeddha1,2, Lucy Atkins3, Ronald de Groot4
1Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands.
Insights
Group A streptococcal (GAS) infections are increasing globally, causing severe illness and disability in hospitalized children. Early recognition and prevention strategies for GAS disease are crucial for better outcomes.
Area of Science:
- Pediatric Infectious Diseases
- Epidemiology
- Clinical Microbiology
Background:
- Group A streptococcal (GAS) infections show increasing incidence worldwide, with limited epidemiological data in European children.
- GAS is the most frequent pathogen in children hospitalized with community-acquired bacterial infections in Europe.
Purpose of the Study:
- To characterize children hospitalized with GAS infection in European hospitals.
- To identify risk factors for disease severity and disability in pediatric GAS infections.
Main Methods:
- Prospective, multicentre, cohort study of 320 children (1 month to 18 years) across 6 European countries (2012-2016).
- Data collection included demographics, clinical presentation, microbiology, and outcomes.
- GAS detection from normally sterile sites and common infection sites (LRTI, SSTI, bone/joint) were analyzed.
Main Results:
- 61% of patients had sepsis, and 74% had GAS detected from sterile sites.
- Lower respiratory tract infections (LRTI) and infections without a clear focus were more common in pediatric intensive care unit (PICU) admissions.
- Hospital discharge showed 12% overall disability, primarily in PICU patients, including neurodisability and amputation. 2% mortality was observed.
Conclusions:
- GAS infection remains a significant cause of severe disease and morbidity in hospitalized children, despite advances in other vaccine-preventable infections.
- Younger children are particularly vulnerable to severe outcomes, including short- and long-term disability.
- Further research is needed to improve prevention and early detection of GAS disease.
Abstract:
Group A streptococcal (GAS) disease shows increasing incidence worldwide. We characterised children admitted with GAS infection to European hospitals and studied risk factors for severity and disability. This is a prospective, multicentre, cohort study (embedded in EUCLIDS and the Swiss Pediatric Sepsis Study) including 320 children, aged 1 month to 18 years, admitted with GAS infection to 41 hospitals in 6 European countries from 2012 to 2016. Demographic, clinical, microbiological and outcome data were collected. A total of 195 (61%) patients had sepsis. Two hundred thirty-six (74%) patients had GAS detected from a normally sterile site. The most common infection sites were the lower respiratory tract (LRTI) (22%), skin and soft tissue (SSTI) (23%) and bone and joint (19%). Compared to patients not admitted to PICU, patients admitted to PICU more commonly had LRTI (39 vs 8%), infection without a focus (22 vs 8%) and intracranial infection (9 vs 3%); less commonly had SSTI and bone and joint infections (p < 0.001); and were younger (median 40 (IQR 21-83) vs 56 (IQR 36-85) months, p = 0.01). Six PICU patients (2%) died. Sequelae at discharge from hospital were largely limited to patients admitted to PICU (29 vs 3%, p < 0.001; 12% overall) and included neurodisability, amputation, skin grafts, hearing loss and need for surgery. More patients were recruited in winter and spring (p < 0.001).
Conclusion:
In an era of observed marked reduction in vaccine-preventable infections, GAS infection requiring hospital admission is still associated with significant severe disease in younger children, and short- and long-term morbidity. Further advances are required in the prevention and early recognition of GAS disease.
What Is Known:
• Despite temporal and geographical variability, there is an increase of incidence of infection with group A streptococci. However, data on the epidemiology of group A streptococcal infections in European children is limited.
What Is New:
• In a large, prospective cohort of children with community-acquired bacterial infection requiring hospitalisation in Europe, GAS was the most frequent pathogen, with 12% disability at discharge, and 2% mortality in patients with GAS infection. • In children with GAS sepsis, IVIG was used in only 4.6% of patients and clindamycin in 29% of patients.
Related Concept Videos
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:21Rheumatic Heart Disease III: Medical Management
01:30Tonsillitis I: Introduction
Etiology
Three primary contributing factors have been identified.
01:30Acute Pharyngitis
Acute pharyngitis is the inflammation of the back of the throat (pharynx), commonly resulting in a sore throat. It is a frequently encountered condition that prompts individuals to seek medical advice.
Classification
Acute pharyngitis can be categorized based on its underlying cause:
01:23Rheumatic Heart Disease I: Introduction