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Abstract
Invasive Streptococcus pyogenes (S. pyogenes) infections are associated with high morbidity and mortality. It is characterized by the appearance of new clones, which may be associated with certain virulence factors. An increase in cases of invasive S.pyogenes disease was reported in 2022.
Objective: To describe clinical, microbiological, and molecular characteristics of invasive S. pyogenes infections in hospitalized children in a high-complexity pediatric hospital.
Patients and Method: Retrospective cohort. Patients with S. pyogenes isolation in a sterile site hospitalized at the Garrahan Hospital between 01/01/2018 and 31/12/2023 were included. Electronic medical records were reviewed and demographic, clinical, and microbiological data were recorded. Bacteriological subtyping was performed using routine methods and genotyping was performed using whole genome sequencing.
Results: 105 patients were included. 63 were male (60%). The median age was 76 months (IQR 37- 117). 36 patients (34.3%) had underlying disease; the most frequent was oncohematological pathology with 7 (6.7%) patients. The most frequent clinical presentations were skin and soft tissue infection with 45 (42.9%) patients, osteoarticular infections with 31 (29.5%) patients, and pneumonia with 9 (8.6%) patients. 17 patients (16.2%) required intensive care. One patient died related to the infection. 76 serotypes were available for subtyping. M1 predominated during the study period. In 2023, M12 incidence increased.
Conclusions: Active epidemiological surveillance showed changes in the circulating S. pyogenes serotypes and the clinical characteristics of the patients.
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