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- Title
Increased rates of invasive bacterial disease in late 2022.
- Authors
Kyne, Sarah; Ní Shíocháin, Doireann; McDonnell, Caoimhe; Byrne, Aisling; Sutton-Fitzpatrick, Una; Crowley, Niamh; Nertney, Leona; Myers, Conor; Waldron, John; Ahmed, Aneeq; Wrynne, Caragh; Fennell, Jerome; Fitzpatrick, Patrick; Fitzsimons, John J.; Scanlan, Barry; Vaughan, David; Gorman, Kathleen M.; Cunney, Robert; Smyth, Anna E.; Hourihane, Jonathan O'B
- Abstract
Invasive bacterial disease is associated with significant morbidity and mortality. In winter 2022, there was an apparent increased rate of invasive bacterial disease compared to preceding years. Cross-site retrospective analysis of the three Children's Health Ireland (CHI) hospitals looking at children admitted between 1st October 2022–31st December 2022 (Q4) with community-acquired invasive bacterial disease, defined as an abscess in a normally sterile site in the head, neck and chest or isolation or PCR detection of Streptococcus pneumoniae, Neisseria meningitidis, Streptococcus pyogenes (Group A streptococcus) or Haemophilus influenzae from a normally sterile site. Case numbers were compared to Q4 in each of 2018–2021. Eighty-two children met the case definition in Q4 2022 vs 97 (Q4 2018–2021). In 2022, 42/82 (51%) were female, median age 3.75 years (1.5–8.25 years). Only 2 (2%) were immunosuppressed and 2 others (2%) had underlying neurodisability. Fifty (61%) were admitted on second or subsequent presentation to a healthcare setting. Fifty-six (68%) had an abscess in a sterile site. Bloodstream infection (positive blood culture or PCR: 24 (29%)) was the most common site of infection, followed by neck 22 (27%) and intracranial 12 (15%). Group A streptococcus (GAS) 27 (33%) was the most common organism isolated. Seven cases (9%) died in 2022 compared to 2 patients (2%) from 2018 to 2021 (p < 0.05). More children had Paediatric Overall Performance Category (POPC) scores > 1 in 2022 than 2018–2021 (p = 0.003). Conclusion: Invasive bacterial diseases increased in Q4 2022 with higher morbidity and mortality than in the preceding 4 years. Group A streptococcal infection was the most significant organism in 2022. What is known: • Invasive bacterial disease is the leading cause of childhood mortality globally. • There was an increase in cases of invasive Group A streptococcus infections reported in many countries (including Ireland) during the winter of 2022/23. What is new: • Head, neck and chest abscesses increased in Q4 of 2022 compared to the previous 4 years combined. • Invasive bacterial infections in Q4 of 2022 were associated with higher rates of mortality (9%), paediatric intensive care unit (PICU) admission (24%) and requirement for surgical drainage or intervention (67%) than in the preceding years.
- Subjects
BACTERIAL diseases; BACTERIAL meningitis; HAEMOPHILUS diseases; PEDIATRIC intensive care; STREPTOCOCCUS pyogenes; STREPTOCOCCAL diseases; STREPTOCOCCUS pneumoniae
- Publication
European Journal of Pediatrics, 2024, Vol 183, Issue 1, p323
- ISSN
0340-6199
- Publication type
Article
- DOI
10.1007/s00431-023-05282-9