Evidence map›Paper›PMID 31556861›Full record

ArticleCurrent clinical pharmacology2020

Severe Group A and Group B Streptococcus Diseases at a Pediatric ICU: Are they Still Sensitive to the Penicillins?

Kam L Hon, Tai C Chow, Tsun S Cheung, Wai T Lam, Lok T Hung, King W So, I P Margaret, Su Y Qian

Open access · hybridAbstract read
In one paragraph

Article in Current clinical pharmacology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
0.2field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 2 countries.

Kam L HonFaculty of Medicine, The Chinese University of Hong Kong, Central Ave, Hong Kong.
Tai C ChowFaculty of Medicine, The Chinese University of Hong Kong, Central Ave, Hong Kong.
Tsun S CheungFaculty of Medicine, The Chinese University of Hong Kong, Central Ave, Hong Kong.
Wai T LamFaculty of Medicine, The Chinese University of Hong Kong, Central Ave, Hong Kong.
Lok T HungFaculty of Medicine, The Chinese University of Hong Kong, Central Ave, Hong Kong.
King W SoDepartment of Paediatrics, The Chinese University of Hong Kong, Central Ave, Hong Kong.
I P MargaretDepartment of Microbiology, The Chinese University of Hong Kong, Central Ave, Hong Kong.
Su Y QianBeijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China.
Chinese University of Hong Kong · HKCapital Medical University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGroup A β-hemolytic Streptococcus (GAS) and Group B streptococcus (GBS) are two common pathogens that are associated with many diseases in children. Severe infections as a result of these two streptococci are albeit uncommon but associated with high mortality and morbidity, and often necessitate intensive care support. This paper aims to review the mortality and morbidity of severe infection associated with GAS and GBS isolations at a Pediatric Intensive Care Unit (PICU).

methodsAll children admitted to PICU of a teaching hospital between October 2002 and May 2018 with laboratory-proven GAS and GBS isolations were included.

resultsThere were 19 patients (0.7% PICU admissions) with streptococcal isolations (GAS, n=11 and GBS, n=8). Comparing to GAS, GBS affected infants were younger (median age 0.13 versus 5.47 years, 95% CI, 1.7-8.5, p=0.0003), and cerebrospinal fluids more likely positive (p = 0.0181). All GAS and GBS were sensitive to penicillin (CLSI: MICs 0.06 - 2.0 μg/mL), with the majority of GAS sensitive to clindamycin and erythromycin, and half of the GBS resistant to clindamycin and erythromycin. Co-infections were prevalent, but viruses were only isolated with GAS (p=0.024). Isolation of GAS and GBS was associated with nearly 40% mortality and high rates of mechanical ventilation and inotropic supports. All non-survivors had high mortality (PIM2) and sepsis scores.

conclusionsSevere GAS and GBS are rare but associated with high mortality and rates of mechanical ventilation and inotropic supports in PICU. The streptococci are invariably sensitive to penicillin. The high PIM2 and Sepsis scores suggest that prompt recognition of sepsis and the timely judicious institution of antibiotics and intensive care support may be life-saving for these devastating infections.

Indexed as

Anti-Bacterial AgentsChildChild, PreschoolDrug Resistance, BacterialFemaleHospitals, TeachingHumansInfantIntensive Care Units, PediatricMaleMicrobial Sensitivity TestsPenicillinsRespiration, ArtificialSepsisSeverity of Illness IndexStreptococcal InfectionsAnti-Bacterial AgentsPenicillinsGroup A streptococcusGroup B streptococcusimpetigomortalitypharyngitisPIM 2scarlet feversepsisStreptococcal pyogenestoxic shock syndrome

Identifiers

PMID31556861
PMCPMC7579287
OpenAlexW2976975907

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.