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Published on: February 9, 2011
Epidemiology of pediatric invasive group A streptococcus infection in a Saudi tertiary care center
Anas Ali1, Raghad Alhuthil1, Deema Gashgarey1
1From the Pediatrics & Women Centre of Excellence, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Insights
Pediatric invasive group A Streptococcus (iGAS) infections in Saudi Arabia are severe, often occurring in children with underlying health conditions. Vigilance and improved surveillance are crucial for managing these serious iGAS infections.
Area of Science:
- Pediatric infectious diseases
- Streptococcal infections
- Public health surveillance
Background:
- Invasive group A Streptococcus (iGAS) infections pose a severe threat to children globally, with rising post-pandemic rates.
- Limited data exists on pediatric iGAS in Saudi Arabia, necessitating local investigation.
Purpose of the Study:
- To assess the clinical characteristics, outcomes, and epidemiological patterns of pediatric iGAS infections.
- To provide insights into iGAS burden at a tertiary care center in Riyadh, Saudi Arabia.
Main Methods:
- A retrospective case series study was conducted.
- Data was collected from pediatric patients (≤14 years) diagnosed with iGAS via positive culture between January 2018 and May 2025.
- King Faisal Specialist Hospital and Research Centre (KFSHRC) in Riyadh served as the study setting.
Main Results:
- Out of 585 infections, 32 pediatric iGAS cases were identified.
- Most iGAS cases occurred during winter/spring (November-April), with increased incidence during COVID-19 pandemic years.
- Common presentations included bacteremia (53%), cellulitis/necrotizing fasciitis (28%), and pneumonia (25%). High comorbidity (94%) was noted, primarily congenital heart disease and hematology/oncology conditions.
- Eleven children (34%) required intensive care, and the mortality rate was 9% (3/32), exclusively among patients with bacteremia.
Conclusions:
- Pediatric iGAS infections in this Saudi Arabian center are associated with significant comorbidity and disease severity.
- Findings highlight the need for increased vigilance in high-risk children, enhanced diagnostic capabilities, and robust local surveillance systems.
- Optimized prevention and management strategies are essential for addressing the burden of severe iGAS infections in pediatric populations.
Background:
Invasive group A Streptococcus (iGAS) infections in children can cause severe illness and lead to high rates of complications and death. While recent global reports show a rise in pediatric iGAS after the COVID-19 pandemic, there is limited data from Saudi Arabia.
Objectives:
Assess the clinical features, outcomes, and patterns of pediatric iGAS at a major tertiary center in Riyadh.
Design:
Retrospective case series study.
Setting:
King Faisal Specialist Hospital and Research Centre (KFSHRC), Riyadh, Saudi Arabia.
Patients And Methods:
Pediatric patients aged 14 years or younger who had symptoms of iGAS confirmed by a positive culture from January 2018 to May 2025.
Main Outcomes Measures:
Clinical features, outcomes, and patterns of pediatric iGAS.
Sample Size:
32 children.
Results:
Out of the 585 total infections recorded, 32 cases were classified as iGAS and included in the study. Most infections happened in winter and spring, with (433/585) 74% occurring from November to April. The highest rates of iGAS were seen during the COVID-19 pandemic years. The average age of patients was 4.1 years, and 94% (n=30) had other health problems, mainly congenital heart disease (n=9, 28%) and hematology/oncology (n=8, 25%). Bacteremia was the most common presentation (n=17, 53%), followed by cellulitis/necrotizing fasciitis (n=9, 28%) and pneumonia (n=8, 25%). Eleven children (34%) needed intensive care, and the overall death rate was 9% (3/32), with all deaths in patients who had bacteremia.
Conclusion:
In our center, pediatric iGAS infections carry a substantial comorbidity and disease severity burden, frequently presenting with complex and aggressive clinical manifestations. These findings underscore the urgent need for heightened vigilance in high-risk children, improved diagnostic precision, and strengthened local surveillance systems to enhance prevention and optimize management of these serious infections.
Limitations:
Single-center, retrospective design and absence of rapid diagnostic testing.
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