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Preadmission course and management of severe pediatric group A streptococcal infections during the 2022–2023 outbreak: a single-center experience.
- Source :
- Infection; Aug2024, Vol. 52 Issue 4, p1397-1405, 9p
- Publication Year :
- 2024
-
Abstract
- Purpose: The massive increase of infections with Group A Streptococcus (GAS) in 2022–2023 coincided in Switzerland with a change of the recommendations for the management of GAS pharyngitis. Therefore, the objective of the present study was to investigate whether the clinical manifestations and management before hospitalization for GAS infection differed in 2022–2023 compared with 2013–2022. Methods: Retrospective study of GAS infections requiring hospitalization in patients below 16 years. Preadmission illness (modified McIsaac score), oral antibiotic use, and outcome in 2022–2023 were compared with 2013–2022. Time series were compared with surveillance data for respiratory viruses. Results: In 2022–2023, the median modified McIsaac score was lower (2 [IQR 2–3] vs. 3 [IQR 2–4], p = < 0.0001) and the duration of preadmission illness was longer (4 days [3–7] vs. 3 [2–6], p = 0.004) than in 2013–2022. In both periods, withholding of preadmission oral antibiotics despite a modified McIsaac score ≥ 3 (12% vs. 18%, n.s.) or ≥ 4 (2.4% vs. 10.0%, p = 0.027) was rare. Respiratory disease, skeletal/muscle infection, and invasive GAS disease were significantly more frequent in 2022–2023, but there were no differences in clinical outcome. The time course of GAS cases in 2022–2023 coincided with the activity of influenza A/B. Conclusion: We found no evidence supporting the hypothesis that the 2022–2023 GAS outbreak was associated with a change in preadmission management possibly induced by the new recommendation for GAS pharyngitis. However, clinical manifestations before admission and comparative examination of time-series strongly suggest that viral co-circulation played an important role in this outbreak. [ABSTRACT FROM AUTHOR]
- Subjects :
- ANTIBIOTICS
STATISTICAL models
ACADEMIC medical centers
SKELETAL muscle
DISEASE duration
OUTPATIENT services in hospitals
RESPIRATORY infections
HOSPITAL care
PHARYNGITIS
MUSCULOSKELETAL system diseases
FISHER exact test
MULTIPLE regression analysis
SEVERITY of illness index
RETROSPECTIVE studies
ORAL drug administration
DESCRIPTIVE statistics
INFLUENZA
CHI-squared test
MANN Whitney U Test
MULTIVARIATE analysis
ODDS ratio
STATISTICS
STREPTOCOCCAL diseases
CONFIDENCE intervals
DATA analysis software
VIRUS diseases
COVID-19 pandemic
TIME
SYMPTOMS
ADOLESCENCE
CHILDREN
Subjects
Details
- Language :
- English
- ISSN :
- 03008126
- Volume :
- 52
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- Infection
- Publication Type :
- Academic Journal
- Accession number :
- 178774642
- Full Text :
- https://doi.org/10.1007/s15010-024-02198-w