Invasive group A streptococcal infections as a consequence of coexisting or previous viral infection in the post-COVID-19 pandemic period

Abstract

Background: Group A Streptococci (GAS) may cause infections of the pharynx and soft tissues and invasive infections in children (iGAS). A significant increase in severe iGAS infections has been reported in Europe since the fall of 2022. Objectives: This retrospective study aims to analyse clinical data of children with invasive and non-invasive GAS infections in the post-COVID-19 pandemic era, searching for predisposing factors to developing invasive infections. Methods: History and clinical data of patients hospitalised due to or with coexisting GAS infections were analysed. iGAS and non-iGAS infections were compared. Results: The cohort comprised 45 children (median age 7 years). 31(69 %) children developed iGAS infections - sepsis with toxic shock syndrome (TSS) (4 children-13 %), deep soft tissue infections (3–10 %), meningitis (2–6 %), pneumonia (2–6 %) or respiratory tract infections – sinusitis or otitis (4–12 %). iGAS children developed complications more frequently (100 % vs 21 %, p 14.94 mg/dl showed 68.2 % sensitivity (CI 45.13–86.14 %) and 100 % specificity (69.15–100 %). Conclusion: Our study shows increased incidence and severity of GAS infections among hospitalised children. Previous or coexisting viral infections and CRP with cut-off > 14.94 mg/dl were significant risk factors.

Keywords

• GAS
• Invasive infections
• Streptococcus pyogenes
• Outbreak
• Children