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Invasive group A streptococcal infection in children: clinical manifestations and molecular characterization in a French pediatric tertiary care center

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Abstract

Invasive group A streptococcal (GAS) infections have a broad and evolving clinical spectrum, associated with various GAS genotypes and/or virulence factors that are only poorly described in children. We aimed to assess the clinical and molecular characteristics of invasive GAS infections in 28 children admitted from 2000 to 2007 at a large French pediatric tertiary care center. The GAS isolates were characterized molecularly by emm-typing and by the determination of the main virulence factors: speA, speB, speC, smeZ-1, ssa, sic, and silC. The median age of the children was 2.9 years. Osteoarticular infection (OAI) was the main clinical manifestation (n = 15/28, 53%). emm-1 predominated (n = 10/28), followed by emm-12, 3, and 4. No significant correlation was found between emm type and clinical manifestations, but emm-1 predominated in cases of OAI (n = 7/15) and was associated with speA, speB, smeZ-1, and sic virulence factor genes. In this pediatric study, we describe a predominance of OAI associated with emm-1 GAS. Further larger international pediatric studies, including host immunity evaluation, are needed in order to better assess the pathogenesis of GAS infection in children.

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References

  1. Cunningham MW (2000) Pathogenesis of group A streptococcal infections. Clin Microbiol Rev 13(3):470–511

    Article  CAS  PubMed  Google Scholar 

  2. Cimolai N, Trombley C, Adderley RJ, Tredwell SJ (1992) Invasive Streptococcus pyogenes infections in children. Can J Public Health 83(3):230–233

    CAS  PubMed  Google Scholar 

  3. Davies HD, Matlow A, Scriver SR, Schlievert P, Lovgren M, Talbot JA et al (1994) Apparent lower rates of streptococcal toxic shock syndrome and lower mortality in children with invasive group A streptococcal infections compared with adults. Pediatr Infect Dis J 13(1):49–56

    Article  CAS  PubMed  Google Scholar 

  4. Mulla ZD (2007) Clinical and epidemiologic features of invasive group A streptococcal infections in children. Pediatr Int 49(3):355–358

    Article  PubMed  Google Scholar 

  5. Beall B, Facklam R, Thompson T (1996) Sequencing emm-specific PCR products for routine and accurate typing of group A streptococci. J Clin Microbiol 34(4):953–958

    CAS  PubMed  Google Scholar 

  6. Schmitz FJ, Beyer A, Charpentier E, Normark BH, Schade M, Fluit AC et al (2003) Toxin-gene profile heterogeneity among endemic invasive European group A streptococcal isolates. J Infect Dis 188(10):1578–1586

    Article  CAS  PubMed  Google Scholar 

  7. Bidet P, Courroux C, Salgueiro C, Carol A, Mariani-Kurkdjian P, Bonacorsi S et al (2007) Molecular epidemiology of the sil streptococcal invasive locus in group A streptococci causing invasive infections in French children. J Clin Microbiol 45(6):2002–2004

    Article  CAS  PubMed  Google Scholar 

  8. Darenberg J, Luca-Harari B, Jasir A, Sandgren A, Pettersson H, Schalén C et al (2007) Molecular and clinical characteristics of invasive group A streptococcal infection in Sweden. Clin Infect Dis 45(4):450–458

    Article  CAS  PubMed  Google Scholar 

  9. Rivera A, Rebollo M, Miró E, Mateo M, Navarro F, Gurguí M et al (2006) Superantigen gene profile, emm type and antibiotic resistance genes among group A streptococcal isolates from Barcelona, Spain. J Med Microbiol 55(Pt 8):1115–1123

    Article  CAS  PubMed  Google Scholar 

  10. Minodier P, Bidet P, Rallu F, Tapiero B, Bingen E, Ovetchkine P (2009) Clinical and microbiologic characteristics of group A streptococcal necrotizing fasciitis in children. Pediatr Infect Dis J 28(6):541–543

    Article  PubMed  Google Scholar 

  11. Lamagni TL, Darenberg J, Luca-Harari B, Siljander T, Efstratiou A, Henriques-Normark B et al (2008) Epidemiology of severe Streptococcus pyogenes disease in Europe. J Clin Microbiol 46(7):2359–2367

    Article  PubMed  Google Scholar 

  12. Lesko SM, O’Brien KL, Schwartz B, Vezina R, Mitchell AA (2001) Invasive group A streptococcal infection and nonsteroidal antiinflammatory drug use among children with primary varicella. Pediatrics 107(5):1108–1115

    Article  CAS  PubMed  Google Scholar 

  13. O’Loughlin RE, Roberson A, Cieslak PR, Lynfield R, Gershman K, Craig A et al (2007) The epidemiology of invasive group A streptococcal infection and potential vaccine implications: United States, 2000–2004. Clin Infect Dis 45(7):853–862

    Article  PubMed  Google Scholar 

  14. Factor SH, Levine OS, Harrison LH, Farley MM, McGeer A, Skoff T et al (2005) Risk factors for pediatric invasive group A streptococcal disease. Emerg Infect Dis 11(7):1062–1066

    PubMed  Google Scholar 

  15. Lamagni TL, Efstratiou A, Vuopio-Varkila J, Jasir A, Schalén C (2005) The epidemiology of severe Streptococcus pyogenes associated disease in Europe. Euro Surveill 10(9):179–184

    CAS  PubMed  Google Scholar 

  16. Stevens DL (1992) Invasive group A streptococcus infections. Clin Infect Dis 14(1):2–11

    CAS  PubMed  Google Scholar 

  17. O’Brien KL, Beall B, Barrett NL, Cieslak PR, Reingold A, Farley MM et al (2002) Epidemiology of invasive group a streptococcus disease in the United States, 1995–1999. Clin Infect Dis 35(3):268–276

    Article  PubMed  Google Scholar 

  18. Vlaminckx BJ, van Pelt W, Schouls LM, van Silfhout A, Mascini EM, Elzenaar CP et al (2005) Long-term surveillance of invasive group A streptococcal disease in The Netherlands, 1994–2003. Clin Microbiol Infect 11(3):226–231

    Article  CAS  PubMed  Google Scholar 

  19. Luca-Harari B, Darenberg J, Neal S, Siljander T, Strakova L, Tanna A et al (2009) Clinical and microbiological characteristics of severe Streptococcus pyogenes disease in Europe. J Clin Microbiol 47(4):1155–1165

    Article  CAS  PubMed  Google Scholar 

  20. Vlaminckx BJ, Mascini EM, Schellekens J, Schouls LM, Paauw A, Fluit AC et al (2003) Site-specific manifestations of invasive group a streptococcal disease: type distribution and corresponding patterns of virulence determinants. J Clin Microbiol 41(11):4941–4949

    Article  CAS  PubMed  Google Scholar 

  21. McMillan DJ, Beiko RG, Geffers R, Buer J, Schouls LM, Vlaminckx BJ et al (2006) Genes for the majority of group a streptococcal virulence factors and extracellular surface proteins do not confer an increased propensity to cause invasive disease. Clin Infect Dis 43(7):884–891

    Article  CAS  PubMed  Google Scholar 

  22. Richter SS, Heilmann KP, Beekmann SE, Miller NJ, Miller AL, Rice CL et al (2005) Macrolide-resistant Streptococcus pyogenes in the United States, 2002–2003. Clin Infect Dis 41(5):599–608

    Article  CAS  PubMed  Google Scholar 

  23. Tanz RR, Shulman ST, Shortridge VD, Kabat W, Kabat K, Cederlund E et al (2004) Community-based surveillance in the United States of macrolide-resistant pediatric pharyngeal group A streptococci during 3 respiratory disease seasons. Clin Infect Dis 39(12):1794–1801

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Assistance Publique des Hôpitaux de Paris, Pédiatrie Générale, Pôle de Pédiatrie Aigue et Médecine Interne, Hôpital Robert Debré, Paris, France

    S. Henriet, M. Lorrot, A. De Lauzanne & A. Faye

  2. UFR de Médecine, Université Paris Diderot, 10 Avenue De Verdun, 75010, Paris, France

    F. Kaguelidou, M. Lorrot, S. Dauger, J.-C. Mercier, C. Alberti & A. Faye

  3. Assistance Publique des Hôpitaux de Paris, Unité d’Epidémiologie Clinique, Hôpital Robert Debré, Paris, France

    F. Kaguelidou & C. Alberti

  4. INSERM CIE 5, Paris, France

    F. Kaguelidou & C. Alberti

  5. Assistance Publique des Hôpitaux de Paris, Laboratoire de Microbiologie et Laboratoire Associé au Centre National de Référence du Streptocoque A, Hôpital Robert Debré, Paris, France

    P. Bidet & E. Bingen

  6. UFR de Médecine, EA 3105 Université Paris Diderot, 10 Avenue De Verdun, 75010, Paris, France

    P. Bidet & E. Bingen

  7. Assistance Publique des Hôpitaux de Paris, Réanimation Polyvalente, Pôle de Pédiatrie Aigue et Médecine Interne, Hôpital Robert Debré, Paris, France

    S. Dauger

  8. Assistance Publique des Hôpitaux de Paris, Urgences Pédiatriques, Pôle de Pédiatrie Aigue et Médecine Interne, Hôpital Robert Debré, Paris, France

    F. Angoulvant & J.-C. Mercier

  9. Service de Pédiatrie Générale, Hôpital Robert Debré, 48 Boulevard Sérurier, 75019, Paris, France

    A. Faye

Authors
  1. S. Henriet
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  2. F. Kaguelidou
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  3. P. Bidet
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  4. M. Lorrot
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  5. A. De Lauzanne
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  6. S. Dauger
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  7. F. Angoulvant
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  8. J.-C. Mercier
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  9. C. Alberti
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  10. E. Bingen
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  11. A. Faye
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Corresponding author

Correspondence to A. Faye.

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Henriet, S., Kaguelidou, F., Bidet, P. et al. Invasive group A streptococcal infection in children: clinical manifestations and molecular characterization in a French pediatric tertiary care center. Eur J Clin Microbiol Infect Dis 29, 341–346 (2010). https://doi.org/10.1007/s10096-009-0854-x

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  • DOI: https://doi.org/10.1007/s10096-009-0854-x

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