Group A streptococcal disease in paediatric inpatients: a European perspective.
Group A streptococcal disease in paediatric inpatients: a European perspective.
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DOI：
10.1007/s00431-022-04718-y
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发表时间：
2023-02
影响因子：
3.6
通讯作者：
EUCLIDS consortium
中科院分区：
文献类型：
--
作者：
Boeddha NP;Atkins L;de Groot R;Driessen G;Hazelzet J;Zenz W;Carrol ED;Anderson ST;Martinon-Torres F;Agyeman PKA;Galassini R;Herberg J;Levin M;Schlapbach LJ;Emonts M;EUCLIDS consortium
A组链球菌（GAS）疾病在世界范围内的发病率不断增加。我们对欧洲医院收治的GAS感染儿童进行了特征分析，并研究了严重程度和残疾的风险因素。这是一项前瞻性、多中心、队列研究（嵌入EUCLIDS和瑞士儿科败血症研究），包括2012年至2016年在6个欧洲国家的41家医院收治的320名1个月至18岁的GAS感染儿童。收集人口统计学、临床、微生物学和结局数据。共有195例（61%）患者发生脓毒症。236例（74%）患者在正常无菌部位检测到GAS。最常见的感染部位是下呼吸道（22%）、皮肤和软组织（23%）和骨关节（19%）。与未入住PICU的患者相比，入住PICU的患者更常见LRTI（39 vs 8%），无病灶感染（22 vs 8%）和颅内感染（9 vs 3%）; SSTI和骨关节感染较不常见（p < 0.001）;年轻（中位数40（IQR 21-83）vs 56（IQR 36-85）个月，p = 0.01）。6例PICU患者（2%）死亡。出院时的后遗症主要限于PICU患者（29 vs 3%，p < 0.001;总体为12%），包括神经功能障碍、截肢、皮肤移植、听力损失和手术需求。冬季和春季招募的患者较多（p < 0.001）。结论：在一个观察到疫苗可预防感染显著减少的时代，需要住院的GAS感染仍然与年幼儿童的严重疾病以及短期和长期发病率相关。在GAS疾病的预防和早期识别方面需要进一步的进展。 在线版本包含补充材料，可通过10.1007/s 00431 -022-04718-y获得。
Group A streptococcal (GAS) disease shows increasing incidence worldwide. We characterised children admitted with GAS infection to European hospitals and studied risk factors for severity and disability. This is a prospective, multicentre, cohort study (embedded in EUCLIDS and the Swiss Pediatric Sepsis Study) including 320 children, aged 1 month to 18 years, admitted with GAS infection to 41 hospitals in 6 European countries from 2012 to 2016. Demographic, clinical, microbiological and outcome data were collected. A total of 195 (61%) patients had sepsis. Two hundred thirty-six (74%) patients had GAS detected from a normally sterile site. The most common infection sites were the lower respiratory tract (LRTI) (22%), skin and soft tissue (SSTI) (23%) and bone and joint (19%). Compared to patients not admitted to PICU, patients admitted to PICU more commonly had LRTI (39 vs 8%), infection without a focus (22 vs 8%) and intracranial infection (9 vs 3%); less commonly had SSTI and bone and joint infections (p < 0.001); and were younger (median 40 (IQR 21–83) vs 56 (IQR 36–85) months, p = 0.01). Six PICU patients (2%) died. Sequelae at discharge from hospital were largely limited to patients admitted to PICU (29 vs 3%, p < 0.001; 12% overall) and included neurodisability, amputation, skin grafts, hearing loss and need for surgery. More patients were recruited in winter and spring (p < 0.001). Conclusion: In an era of observed marked reduction in vaccine-preventable infections, GAS infection requiring hospital admission is still associated with significant severe disease in younger children, and short- and long-term morbidity. Further advances are required in the prevention and early recognition of GAS disease. The online version contains supplementary material available at 10.1007/s00431-022-04718-y.
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影响因子：
36.4
作者：
Agyeman, Philipp K. A.;Schlapbach, Luregn J.;Berger, Christoph
通讯作者：
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