Current Clinical Practice on the Management of Invasive Streptococcus Pyogenes Infections in Children: A Survey-Based...

Area of Science:

• Pediatric Infectious Diseases
• Microbiology
• Clinical Practice Guidelines

Background:

• Group A Streptococcus (GAS) causes a range of illnesses, from mild to severe invasive infections.
• Re-emergence of hypervirulent GAS strains raises global health concerns, especially for pediatric populations.
• Lack of universal guidelines necessitates reliance on clinical judgment for managing invasive GAS (iGAS) infections.

Purpose of the Study:

• To evaluate current management practices for invasive GAS (iGAS) infections in Italy.
• To identify variability in therapeutic and preventive strategies among Italian clinicians.

Main Methods:

• A web-based survey on invasive and severe GAS infections was conducted.
• The survey followed the Checklist for Reporting of Survey Studies (CROSS) methodology.
• Participants included members of the Italian Society of Pediatric Infectious Diseases (SITIP).

Main Results:

• Consensus exists on first-line therapies (penicillin/ceftriaxone) but uncertainty surrounds combined antibiotic regimens and supportive treatments.
• Combined antibiotic therapy (clindamycin or linezolid) is favored for severe conditions like STSS, NF, and brain abscesses.
• Significant disagreement noted on de-escalation timing, IVIG use/dosages, and corticosteroid administration.

Conclusions:

• Effective management of pediatric iGAS infections requires improved surveillance, early detection, and prompt treatment.
• Developing national registries and country-specific guidelines is crucial for standardizing care and building evidence.
• Further research is needed to establish the most effective therapeutic and preventive strategies for iGAS infections in children.