Epidemiology and clinical features of Streptococcus pyogenes bloodstream infections in children in Madrid, Spain.

Autor: Cobo-Vázquez E; Department of Pediatrics, Hospital Universitario Fundación de Alcorcón, Servicio de Pediatría, Calle Budapest Nº1, 28922, Alcorcón, Madrid, Spain.; PhD Program in Medicine, Universidad Complutense de Madrid, Madrid, Spain., Aguilera-Alonso D; PhD Program in Medicine, Universidad Complutense de Madrid, Madrid, Spain. david.aguilera@salud.madrid.org.; Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital General Universitario Gregorio Marañón. CIBER de enfermedades infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Servicio de Pediatría, Calle de O'Donnell, Madrid, 28009, Madrid, Spain. david.aguilera@salud.madrid.org., Carbayo T; Department of Neonatology, Hospital Universitario, 12 de Octubre, Madrid, Spain., Figueroa-Ospina LM; Department of Pediatrics, Hospital General de Villalba, Villalba, Madrid, Spain., Sanz-Santaeufemia F; Department of Pediatrics, Hospital Universitario Niño Jesús, Madrid, Spain., Baquero-Artigao F; Department of Infectious Diseases and Tropical Pediatrics, Hospital Universitario La Paz and IdiPaz Foundation, Madrid, Spain.; RITIP, Translational Research Network in Pediatric Infectious Diseases, CIBER de enfermedades infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Universidad Autónoma, Madrid, Spain., Vázquez-Ordoñez C; Department of Pediatrics, Hospital, Universitario Ramón y Cajal, Madrid, Spain., Carrasco-Colom J; Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital Universitario La Moraleja, Madrid, Spain.; Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital Universitari Son Espases, Palma de Mallorca, Spain., Blázquez-Gamero D; Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre (imas12). Universidad Complutense, RITIP, Madrid, Spain., Jiménez-Montero B; Department of Pediatrics, Hospital Clínico San Carlos, Madrid, Spain., Grasa-Lozano C; Department of Infectious Diseases and Tropical Pediatrics, Hospital Universitario La Paz and IdiPaz Foundation, Madrid, Spain.; RITIP, Translational Research Network in Pediatric Infectious Diseases, CIBER de enfermedades infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Universidad Autónoma, Madrid, Spain.; Department of Pediatrics, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain., Cilleruelo MJ; Department of Pediatrics, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain., Álvarez A; Department of Pediatrics, Hospital Universitario de Getafe, Getafe, Madrid, Spain., Comín-Cabrera C; Department of Pediatrics, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain., Penin M; Department of Pediatrics, Hospital, Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain., Cercenado E; Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain., Del Valle R; Department of Pediatrics, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain., Roa MÁ; Department of Pediatrics, Hospital Universitario de Móstoles, Móstoles, Madrid, Spain., Diego IG; Department of Pediatrics, Hospital Universitario del Tajo, Aranjuez, Madrid, Spain., Calvo C; Department of Infectious Diseases and Tropical Pediatrics, Hospital Universitario La Paz and IdiPaz Foundation, Madrid, Spain.; RITIP, Translational Research Network in Pediatric Infectious Diseases, CIBER de enfermedades infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Universidad Autónoma, Madrid, Spain., Saavedra-Lozano J; Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital General Universitario Gregorio Marañón, CIBER de enfermedades infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Universidad Complutense, Madrid, Spain.
Jazyk: angličtina
Zdroj: European journal of pediatrics [Eur J Pediatr] 2023 Jul; Vol. 182 (7), pp. 3057-3062. Date of Electronic Publication: 2023 May 04.
DOI: 10.1007/s00431-023-04967-5
Abstrakt: Studies have shown increased invasive Group A Streptococcus (GAS) disease, including bloodstream infections (GAS-BSI). However, the epidemiological data of GAS-BSI are limited in children. We aimed to describe GAS-BSI in children in Madrid, over 13 years (2005-2017). Multicenter retrospective cohort study from 16 hospitals from Madrid, Spain. Epidemiology, symptomatology, laboratory, treatment, and outcome of GAS-BSI in children ≤ 16 years were analyzed. 109 cases of GAS-BSI were included, with incidence rate of 4.3 episodes/100,000 children attended at the emergency department/year. We compared incidence between two periods (P1: 2005-June 2011 vs P2: July 2011-2017) and observed a non-significant increase along the study period (annual percentage change: + 6.0% [95%CI: -2.7, + 15.4]; p = 0.163). Median age was 24.1 months (IQR: 14.0-53.7), peaking during the first four years of life (89/109 cases; 81.6%). Primary BSI (46.8%), skin and soft tissue (21.1%), and osteoarticular infections (18.3%) were the most common syndromes. We compared children with primary BSI with those with a known source and observed that the former had shorter hospital stay (7 vs. 13 days; p = 0.003) and received intravenous antibiotics less frequently (72.5% vs. 94.8%; p = 0.001) and for shorter duration of total antibiotic therapy (10 vs. 21 days; p = 0.001). 22% of cases required PICU admission. Factors associated with severity were respiratory distress, pneumonia, thrombocytopenia, and surgery, but in multivariate analysis, only respiratory distress remained significant (adjusted OR:9.23 [95%CI: 2.16-29.41]). Two children (1.8%) died.   Conclusion: We observed an increasing, although non-significant, trend of GAS-BSI incidence within the study. Younger children were more frequently involved, and primary BSI was the most common and less severe syndrome. PICU admission was frequent, being respiratory distress the main risk factor. What is known: • In recent decades, several reports have shown a worldwide increase in the incidence of invasive Group A streptococcal disease (GAS), including bloodstream infection (BSI). Recently, there have been a few reports showing an increase in severity as well. • There needs to be more information on the epidemiology in children since most studies predominantly include adults. What is new: • This study, carried out in children with GAS-BSI in Madrid, shows that GAS-BSI affects mostly younger children, with a broad spectrum of manifestations, needing PICU admission frequently. Respiratory distress was the leading risk factor for severity, whereas primary BSI seemed to be less severe. • We observed an increasing, although non-significant, trend of GAS-BSI incidence in recent years (2005-2017).
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje