Invasive Group A Streptococcal Infections in Pediatric Critical Care: A Retrospective Cohort Study

Area of Science:

• Pediatric Critical Care Medicine
• Infectious Diseases
• Epidemiology

Background:

• Rising global rates of invasive group A Streptococcus (iGAS) infection are increasing critical illness and fatalities.
• Understanding iGAS presentations and clinical course in children is crucial for early recognition and treatment.
• This study addresses the epidemiology of iGAS infections in critically ill children.

Purpose of the Study:

• To describe the epidemiology of iGAS infections among children admitted to critical care.
• To analyze clinical characteristics, therapies, functional outcomes, and mortality in pediatric iGAS cases.
• To provide insights into the clinical course of iGAS in a Canadian PICU setting.

Main Methods:

• Retrospective cohort study of children (0-18 years) diagnosed with iGAS infection.
• Data collected from The Hospital for Sick Children, Toronto, Canada (March 2022 - June 2023).
• Analysis included proportion of iGAS admissions, clinical features, therapies, functional status, and mortality.

Main Results:

• 29 (1.6%) of 1820 PICU admissions were due to iGAS infection.
• 80% (23/29) of children with iGAS survived to hospital discharge.
• 61% of survivors returned to their baseline functional status by discharge, with generally favorable outcomes.

Conclusions:

• This is the first report on critically ill children with iGAS in Canada during a period of increased global incidence.
• The study describes the clinical course of iGAS in PICU patients with access to advanced interventions.
• Despite high mortality, survivors of severe iGAS infection demonstrate favorable functional outcomes.