2026-04-13T15:13:36Zhttps://recercat.cat/oai/requestoai:recercat.cat:11351/139212025-10-24T10:24:09Zcom_2072_378070com_2072_378040col_2072_378092
RECERCAT
author
Cobo-Vázquez, Elvira
author
Gamell, Anna
author
Oltra-Benavent, Manuel
author
Aguilera Alonso, David
author
Grandioso, David
author
Rello-Saltor, Victòria
author
Lung, Mayli
2025-10-24T10:24:09Z
2025-10-24T10:24:09Z
2025-10-22T12:46:11Z2025-10-22T12:46:11Z2025-10
http://hdl.handle.net/11351/13921
Children; Group A streptococcus; OutbreakNiños; Estreptococo del grupo A; BroteInfants; Estreptococ del grup A; BroteObjectives
A global surge in pediatric invasive group A streptococcal infection (iGAS) was reported after autumn 2022. This study analyzed the epidemiology and severity of iGAS in Spain, comparing two periods; P1: pre-outbreak (January 2019-September 2022) versus P2: outbreak (October 2022-July 2023).
Methods
Children ≤16 years with iGAS enrolled in the Spanish PedGAS-net (2019-2023), were included. Bacterial isolates were analyzed for emm typing, antibiotic susceptibility, and whole genome sequencing. Multivariate analysis identified risk factors for PICU admission and mortality.
Results
558 cases were included; 307 (55.1%) were male, with a median age of 43.9 months (IQR:19.3-84.1). There were significantly more iGAS in P2 (35.7 vs. 4.5 cases/month, P < 0.001), with higher PICU admissions (51.3% vs. 30.8%, P < 0.001). Pneumonia was the most common syndrome (32.3%), with pleural effusion in 58.3%. Of the 130 samples available for emm-typing, the most frequent were emm1 (56.1%) and emm12 (27.1%). 245 (43.9%) required PICU admission. Factors associated with PICU were streptococcal toxic shock syndrome (STSS), pneumonia, necrotizing fasciitis, acute kidney failure, and previous consultation before diagnosis. The emm1 (especially M1UK) increased PICU risk. 11 children (2.0%) died. STSS, sepsis, and central nervous system infection were associated with mortality.
Conclusion
In Spain, pediatric iGAS cases sharply increased during 2022-2023, with a remarkable increase in severity. Epidemiological surveillance of iGAS remains crucial.This work was partially funded by the Centro de Investigación Biotecnológica en Red de Enfermedades Infecciosas (CIBERINFEC: IM23/INFEC/3).
Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess
Pandèmia de COVID-19, 2020-
Infants
Infeccions per estreptococs - Epidemiologia
Streptococcus pyogenes
DISEASES::Bacterial Infections and Mycoses::Bacterial Infections::Gram-Positive Bacterial Infections::Streptococcal Infections
Other subheadings::Other subheadings::Other subheadings::/epidemiology
ORGANISMS::Bacteria::Firmicutes::Lactobacillales::Streptococcaceae::Streptococcus::Streptococcus pyogenes
NAMED GROUPS::Persons::Age Groups::Child
DISEASES::Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections
HEALTH CARE::Environment and Public Health::Public Health::Disease Outbreaks::Epidemics::Pandemics
ENFERMEDADES::infecciones bacterianas y micosis::infecciones bacterianas::infecciones por bacterias grampositivas::infecciones estreptocócicas
Otros calificadores::Otros calificadores::Otros calificadores::/epidemiología
ORGANISMOS::Bacteria::Firmicutes::Lactobacillales::Streptococcaceae::Streptococcus::Streptococcus pyogenes
DENOMINACIONES DE GRUPOS::personas::Grupos de Edad::niño
ENFERMEDADES::virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus
ATENCIÓN DE SALUD::ambiente y salud pública::salud pública::brotes de enfermedades::epidemias::pandemias
Sharp increase in the incidence and severity of invasive Streptococcus pyogenes infections in children after the COVID-19 pandemic (2019-2023): A nationwide multicenter study
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion