An Australian Paediatric Retrieval Service Riding the Wave of Invasive Group A Streptococcal Disease From 2022 to...

Area of Science:

• Pediatric Infectious Diseases
• Epidemiology
• Critical Care Medicine

Background:

• An increase in invasive group A streptococcus (iGAS) cases was observed globally from late 2022.
• A corresponding rise in iGAS disease referrals to Newborn and Paediatric Emergency Transport service (NETS NSW) in New South Wales (NSW), Australia, was noted.
• This study details the clinical features and outcomes of pediatric iGAS cases managed by NETS NSW.

Purpose of the Study:

• To describe the clinical characteristics and outcomes of children referred to NETS NSW with iGAS disease.
• To assess the impact of the iGAS surge on pediatric emergency transport services.
• To highlight the critical care needs of children with severe iGAS infections.

Main Methods:

• A retrospective cohort study of children with confirmed iGAS disease (S. pyogenes from sterile sites) referred to NETS NSW.
• Data collected from medical records for patients between November 1, 2022, and February 29, 2024.
• Inclusion criteria focused on confirmed iGAS diagnosis and referral to NETS NSW.

Main Results:

• Seventy-seven children were referred, with 70 retrieved by NETS NSW; four deaths occurred.
• The majority were preschool-aged males presenting with pneumonia, septic arthritis, or rash.
• High rates of bacteremia, elevated lactate, and critical care needs (PICU, ventilation, ECMO referral) were observed.

Conclusions:

• A significant increase in iGAS disease referrals to NETS NSW occurred between late 2022 and early 2024.
• NETS NSW experienced high demand for critical care transport of severely ill preschool-aged children.
• The findings underscore the need for robust emergency transport systems to manage pediatric infectious disease outbreaks.