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Prospective Surveillance of Pediatric Invasive Group A Streptococcus Infection.
- Source :
-
Journal of the Pediatric Infectious Diseases Society [J Pediatric Infect Dis Soc] 2019 Mar 28; Vol. 8 (1), pp. 46-52. - Publication Year :
- 2019
-
Abstract
- Background: Invasive group A Streptococcus (GAS) disease has an incidence in high-income countries of 3 to 5 per 100000 per annum and a case-fatality ratio of 10% to 15%. Although these rates are comparable to those of invasive meningococcal disease in Australia before vaccine introduction, invasive GAS disease currently requires reporting in only 2 jurisdictions.<br />Methods: Data were collected prospectively through active surveillance at the Royal Children's Hospital, Melbourne (October 2014 to September 2016). Isolation of GAS from a sterile site was required for inclusion. Comprehensive demographic and clinical data were collected, and emm typing was performed on all isolates. Disease was considered severe if the patient required inotropic support or mechanical ventilation.<br />Results: We recruited 28 patients. The median age of the patients was 3.5 years (range, 4 days to 11 years). Ten (36%) patients had severe disease. Fifteen (54%) children had presented to a medical practitioner for review in the 48 hours before their eventual admission, including 7 of the 10 patients with severe GAS infection. Complications 6 months after discharge persisted in 21% of the patients. emm1 was the most common emm type (29%).<br />Conclusion: We found considerable short- and longer-term morbidity associated with pediatric invasive GAS disease in our study. Disease manifestations were frequently severe, and more than one-third of the patients required cardiorespiratory support. More than one-half of the patients attended a medical practitioner for assessment but were discharged in the 48-hour period before admission, which suggests that there might have been a window for earlier diagnosis. Our methodology was easy to implement as a surveillance system.<br /> (© The Author(s) 2017. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Subjects :
- Anti-Bacterial Agents therapeutic use
Australia epidemiology
Child
Child, Preschool
Extracorporeal Membrane Oxygenation
Female
Humans
Incidence
Infant
Infant, Newborn
Male
Population Surveillance
Prospective Studies
Respiratory Therapy
Severity of Illness Index
Streptococcal Infections classification
Streptococcal Infections complications
Streptococcal Infections drug therapy
Streptococcal Infections epidemiology
Streptococcus pyogenes
Subjects
Details
- Language :
- English
- ISSN :
- 2048-7207
- Volume :
- 8
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of the Pediatric Infectious Diseases Society
- Publication Type :
- Academic Journal
- Accession number :
- 29309631
- Full Text :
- https://doi.org/10.1093/jpids/pix099