Title:Group A Streptococcal Infections in Children
Volume: 17
Issue: 1
Author(s): Molla Imaduddin Ahmed*, Rosalind V. Saunders and Srini Bandi
Affiliation:
- Department of Paediatrics, University Hospitals of Leicester NHS Trust, Leicester,United Kingdom
Keywords:
Invasive, streptococcus, Group A, infections, children, iGAS.
Abstract:
Background: Invasive group A streptococcal disease (iGAS) can have varied clinical
presentations in children, are responsible for prolonged hospital stays and can cause mortality and
long-term morbidity in children. Over the last decade, there has been an increase in the incidence of
iGAS infections in the UK and worldwide. This has renewed the focus on early diagnosis, management
and prevention of this disease.
Aims and Objectives: The aim of this study was to review the varied clinical presentations and
management of children with iGAS infections.
Methods: We reviewed the data of children admitted to our tertiary Children’s Hospital who had
positive isolation of Group A Streptococcus( GAS) from sterile site cultures over the last 8 years.
We reviewed their clinical presentations and management including treatment given (antibiotics
and duration), outcome and follow up.
Results: A total of 57 children had iGAS during the study period. The incidence of iGAS was 6-7
cases per year during the study period, except for 2015 when we had 11 cases. The mean length of
stay of children admitted with iGAS was 11 days (range 2– 35 days). 21.1% children were admitted
to intensive care during their hospital stay. Fever was the most common presenting symptom.
Pneumonia with or without empyema was the most common Diagnosis. Initial antibiotic management
was varied with ceftriaxone the most commonly used antibiotic in 30% of the cases. 50% of
children had their antimicrobial therapy optimised to IV benzylpenicillin after the confirmed isolation
of GAS. 7 Children were re-admitted for further treatment and needed a further course of antibiotics.
4 children (7%) died due to iGAS infection.
Conclusion: Our study highlighted the varied symptomatology and management practices in children
with iGAS and showed that early diagnosis and prompt initiation of appropriate antibiotics for
iGAS can help in the resolution of symptoms and good outcomes.
