Details:

Alternative Title:
J Pediatric Infect Dis Soc
Publisher's site:
http://dx.doi.org/10.1093/jpids/piy108
Personal Author:
Link-Gelles, Ruth ; Toews, Karrie-Ann ; Schaffner, William ; Edwards, Kathryn M. ; Wright, Carolyn ; ... More +
Link-Gelles, Ruth ; Toews, Karrie-Ann ; Schaffner, William ; Edwards, Kathryn M. ; Wright, Carolyn ; Beall, Bernard ; Barnes, Brenda ; Jewell, Brenda ; Harrison, Lee H. ; Kirley, Pam D. ; Lorentzson, Lauren ; Aragon, Deborah ; Petit, Susan ; Bareta, Joseph ; Spina, Nancy L. ; Cieslak, Paul R. ; Van Beneden, Chris Less -
Description:
Background.

Few data on intracranial group A Streptococcus (GAS) infection in children are available. Here, we describe the demographic, clinical, and diagnostic characteristics of 91 children with intracranial GAS infection.

Methods.

Cases of intracranial GAS infection in persons ≤18 years of age reported between 1997 and 2014 were identified by the Centers for Disease Control and Prevention’s population- and laboratory-based Active Bacterial Core surveillance (ABCs) system. Medical charts were abstracted using a active, standardized case report form. All available isolates were emm typed. US census data were used to calculate rates.

Results.

ABCs identified 2596 children with invasive GAS infection over an 18-year period; 91 (3.5%) had an intracranial infection. Intracranial infections were most frequent during the winter months and among children aged <1 year. The average annual incidence was 0.07 cases per 100 000 children. For 83 patients for whom information for further classification was available, the principal clinical presentations included meningitis (35 [42%]), intracranial infection after otitis media, mastoiditis, or sinusitis (34 [41%]), and ventriculoperitoneal shunt infection (14 [17%]). Seven (8%) of these infections progressed to streptococcal toxic shock syndrome. The overall case fatality rate was 15%. GAS emm types 1 (31% of available isolates) and 12 (13% of available isolates) were most common.

Conclusions.

Pediatric intracranial (GAS) infections are uncommon but often severe. Risk factors for intracranial GAS infection include the presence of a ventriculoperitoneal shunt and contiguous infections in the middle ear or sinuses.


Subjects:
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Adolescent Age Distribution Article Brain Diseases Central Nervous System Bacterial Infections Child Child, Preschool Female Group A Streptococcus Humans Incidence Infant Male Mastoiditis Meningitis Meningitis, Bacterial Otitis Media Risk Factors Shock, Septic Sinusitis Streptococcal Infections Streptococcus Pyogenes Ventriculoperitoneal Shunt
Source:
J Pediatric Infect Dis Soc. 9(1):30-35
Pubmed ID:
30462264
Pubmed Central ID:
PMC8931553
Document Type:
Journal Article
Funding:
CC999999/ImCDC/Intramural CDC HHSUnited States/
Place as Subject:
United States
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:fa92c887869de39f670c909652d770b15b3cb79af3b667f3d3d23002f1bb7b1c
Download URL:
https://stacks.cdc.gov/view/cdc/115507/cdc_115507_DS1.pdf
File Type:

Supporting Files

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