TY - JOUR T1 - Streptococcus pyogenes infection in paediatrics: from pharyngotonsillitis to invasive infections JO - Anales de Pediatría (English Edition) T2 - AU - Espadas-Maciá,David AU - Flor Macián,Eva María AU - Borrás,Rafael AU - Poujois Gisbert,Sandrine AU - Muñoz Bonet,Juan Ignacio SN - 23412879 M3 - 10.1016/j.anpede.2017.02.013 DO - 10.1016/j.anpede.2017.02.013 UR - https://www.analesdepediatria.org/en-streptococcus-pyogenes-infection-in-paediatrics-articulo-S2341287917302193 AB - BackgroundStreptococcus pyogenes or Group A Streptococci (GAS) cause many infections in infancy. Changes in its epidemiology have been described in recent years, including an increase in invasive infections (iGAS). MethodsA retrospective-descriptive study was conducted on children less than 15-years-old, with GAS infections, in particular iGAS, and their complications from February 2004 to April 2014. ResultsA total of 2192 positive cultures were obtained of which 92.7% were pharyngeal cultures. Twenty-nine patients were admitted to hospital: 4 with suppurative complications, 7 post-infective, 14 iGAS, and 4 probable iGAS cases. There were no differences in the frequency of GAS isolations/year. Non-invasive isolates were more frequent in winter and spring (P<.001), and 68.3% were in patients younger than 5 years.The incidence of iGAS was 2.1/100000 children/year. There was no seasonality, and it was more frequent in younger children (P=.039). The most common diagnosis was pneumonia (6/14). Eight patients required intensive care. They were treated empirically with second or third-generation cephalosporin or with intravenous penicillin, and pneumonia required longer treatment times (P=.016). All GAS isolates were sensitive to penicillin, and 10.6% were resistant to erythromycin. The time spent in hospital was longer for iGAS than other cases (P=.028). No patients died. ConclusionsPharyngotonsillitis caused by GAS is common in childhood, and its incidence is increasing in children younger than 5 years. At the moment, post-infectious complications are rare. Invasive infections are the most severe forms of presentation, and are more common in younger children. ER -