Characteristics of Intracranial Group A Streptococcal Infections in US Children, 1997-2014.

Autor: Link-Gelles R; Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia., Toews KA; Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia., Schaffner W; Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee., Edwards KM; Division of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee., Wright C; Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia., Beall B; Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia., Barnes B; Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee., Jewell B; Minnesota Department of Health, St. Paul., Harrison LH; Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland., Kirley PD; California Emerging Infections Program, Oakland., Lorentzson L; Georgia Department of Public Health, Atlanta., Aragon D; Colorado Department of Public Health and Environment, Denver., Petit S; Connecticut Department of Public Health, Hartford., Bareta J; New Mexico Department of Health, Santa Fe., Spina NL; New York State Department of Health, Albany., Cieslak PR; Oregon Health Authority Public Health Division, Portland., Van Beneden C; Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia.
Jazyk: angličtina
Zdroj: Journal of the Pediatric Infectious Diseases Society [J Pediatric Infect Dis Soc] 2020 Feb 28; Vol. 9 (1), pp. 30-35.
DOI: 10.1093/jpids/piy108
Abstrakt: Background: Few data on intracranial group A Streptococcus (GAS) infection in children are available. Here, we describe the demographic, clinical, and diagnostic characteristics of 91 children with intracranial GAS infection.
Methods: Cases of intracranial GAS infection in persons ≤18 years of age reported between 1997 and 2014 were identified by the Centers for Disease Control and Prevention's population- and laboratory-based Active Bacterial Core surveillance (ABCs) system. Medical charts were abstracted using a active, standardized case report form. All available isolates were emm typed. US census data were used to calculate rates.
Results: ABCs identified 2596 children with invasive GAS infection over an 18-year period; 91 (3.5%) had an intracranial infection. Intracranial infections were most frequent during the winter months and among children aged <1 year. The average annual incidence was 0.07 cases per 100000 children. For 83 patients for whom information for further classification was available, the principal clinical presentations included meningitis (35 [42%]), intracranial infection after otitis media, mastoiditis, or sinusitis (34 [41%]), and ventriculoperitoneal shunt infection (14 [17%]). Seven (8%) of these infections progressed to streptococcal toxic shock syndrome. The overall case fatality rate was 15%. GAS emm types 1 (31% of available isolates) and 12 (13% of available isolates) were most common.
Conclusions: Pediatric intracranial (GAS) infections are uncommon but often severe. Risk factors for intracranial GAS infection include the presence of a ventriculoperitoneal shunt and contiguous infections in the middle ear or sinuses.
(Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society 2018.)
Databáze: MEDLINE
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