Objective The emergence of severe group A streptococcal (GAS) infections has been described during the last decade in many countries. The aim of this study was to examine the epidemiological and clinical characteristics of invasive GAS infections in children in our area.
Methods The cases of children 0-14 years of age admitted at our hospital during a seven year period between 1994 and 2000 were retrospectively reviewed. Cases were included if they had a positive blood or other sterile fluid culture for GAS.
Results. A total of 16 cases were recorded (9 males) with a median age of 54 months (range: 23 days to 13 years). Only one patient with osteomyelitis had concomitant varicella as a predisposing factor and none had an underlying chronic condition. One patient developed streptococcal toxic shock syndrome, 4 bacteremia and 11 a focal infection such as musculoskeletal (6), peural empyema (2), pneumonia with pleuritis (1), meningitis (1) and periorbital cellultis (1). No patient developed necrotizing fasciitis. One of the 14 patients with known outcome died (case fatality rate 7%).
Conclusion GBS may occasionally cause serious infections with considerable morbidity and mortality in our area, suggesting that clone(s) with increased virulence circulate in the community.