Clinical and epidemiologic features of invasive group A streptococcal infections in children

Abstract

Invasive group A streptococcal infection (IGASI) is a disease of public health importance. The clinical epidemiology of IGASI in children has not been studied extensively in Florida, USA. The objective of this study was to describe the clinical and epidemiologic features of children hospitalized for IGASI in Florida, USA, during a 4-year period. Data from a previous retrospective cohort study of IGASI were analyzed. The study subjects were children and adults who had been hospitalized throughout Florida for IGASI between 1996 and 2000 and reported to the Florida Department of Health. A total of 25 patients who were 0 to 17 years of age were identified and included in the current pediatric case series. The median age at the time of admission was 4 years (range, 0.05-17 years). A total of 14 cases (56%) were boys. In total, 18 of the pediatric patients had group A streptococcal bacteremia and three children were diagnosed with group A streptococcal necrotizing fasciitis. Various antibiotic regimens were used. A total of 33% (7/21) of the patients received clindamycin during their hospital stay. Data on mortality were available for 23 pediatric IGASI cases and 205 adult IGASI cases. The mortality rate was 4.4% in children as compared to 19.5% in adults (Fisher's two-sided P = 0.087). The low case-fatality in children was consistent with other pediatric series of IGASI.