Terhi Tapiainen1, Saana Launonen, Marjo Renko, Harri Saxen, Eeva Salo, Matti Korppi, Leena Kainulainen, Tarja Heiskanen-Kosma, Laura Lindholm, Jaana Vuopio, Tiina Huotari, Jarmo Rusanen, Matti Uhari. 1. From the *Department of Pediatrics and Adolescents, Medical Research Center and PEDEGO Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland; †Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; ‡Center for Child Health Research, Tampere University and Tampere University Hospital, Tampere, Finland; §Department of Pediatrics, Turku University Hospital, Turku, Finland; ¶Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland; ‖Bacterial Infections Unit, National Institute of Health and Welfare, Turku, Finland; **Department of Medical Microbiology and Immunology, University of Turku, Turku, Finland; and ††Department of Geography, University of Oulu, Oulu, Finland.
Abstract
BACKGROUND: The incidence of invasive group A streptococcus (iGAS) infections varies in time and geographically for unknown reasons. We performed a nationwide survey to assess the population-based incidence rates and outcomes of children with iGAS infections. METHODS: We collected data on patients from hospital discharge registries and the electronic databases of microbiological laboratories in Finland for the period 1996-2010. We then recorded the emm types or serotypes of the strains. The study physician visited all university clinics and collected the clinical data using the same data entry sheet. RESULTS: We identified 151 children with iGAS infection. Varicella preceded iGAS infection in 20% of cases and fasciitis infection in 83% of cases. The annual incidence rate of iGAS infection was 0.93 per 100,000 in 1996-2000, 1.80 in 2001-2005 and 2.50 in 2006-2010. The proportion of emm 1.0 or T1M1 strains peaked in 1996-2000 and again in 2006-2010, to 44% and 37% of all typed isolates. The main clinical diagnoses of the patients were severe soft-tissue infection (46%), sepsis (28%), empyema (10%), osteoarticular infection (9%) and primary peritonitis (5%). Severe pain was the most typical symptom for soft-tissue infections. More than half of the patients underwent surgery and received clindamycin. The readmission rate was 7%, and the case fatality rate was 2%. CONCLUSIONS: The incidence rate of pediatric iGAS infections tripled during our study. The increase was not, however, the result of a change in the strain types causing iGAS. Varicella immunization would likely have prevented a significant number of the cases.
BACKGROUND: The incidence of invasive group A streptococcus (iGAS) infections varies in time and geographically for unknown reasons. We performed a nationwide survey to assess the population-based incidence rates and outcomes of children with iGAS infections. METHODS: We collected data on patients from hospital discharge registries and the electronic databases of microbiological laboratories in Finland for the period 1996-2010. We then recorded the emm types or serotypes of the strains. The study physician visited all university clinics and collected the clinical data using the same data entry sheet. RESULTS: We identified 151 children with iGAS infection. Varicella preceded iGAS infection in 20% of cases and fasciitis infection in 83% of cases. The annual incidence rate of iGAS infection was 0.93 per 100,000 in 1996-2000, 1.80 in 2001-2005 and 2.50 in 2006-2010. The proportion of emm 1.0 or T1M1 strains peaked in 1996-2000 and again in 2006-2010, to 44% and 37% of all typed isolates. The main clinical diagnoses of the patients were severe soft-tissue infection (46%), sepsis (28%), empyema (10%), osteoarticular infection (9%) and primary peritonitis (5%). Severe pain was the most typical symptom for soft-tissue infections. More than half of the patients underwent surgery and received clindamycin. The readmission rate was 7%, and the case fatality rate was 2%. CONCLUSIONS: The incidence rate of pediatric iGAS infections tripled during our study. The increase was not, however, the result of a change in the strain types causing iGAS. Varicella immunization would likely have prevented a significant number of the cases.
Authors: Ruth Link-Gelles; Karrie-Ann Toews; William Schaffner; Kathryn M Edwards; Carolyn Wright; Bernard Beall; Brenda Barnes; Brenda Jewell; Lee H Harrison; Pam D Kirley; Lauren Lorentzson; Deborah Aragon; Susan Petit; Joseph Bareta; Nancy L Spina; Paul R Cieslak; Chris Van Beneden Journal: J Pediatric Infect Dis Soc Date: 2020-02-28 Impact factor: 3.164
Authors: Teresa Del Rosal; María Belén Caminoa; Alba González-Guerrero; Iker Falces-Romero; María Pilar Romero-Gómez; Fernando Baquero-Artigao; Talía Sainz; Ana Méndez-Echevarría; Luis Escosa-García; Francisco Javier Aracil; Cristina Calvo Journal: Front Pediatr Date: 2020-12-15 Impact factor: 3.418