Evidence map›Paper›PMID 41316382›Full record

Observational studyItalian journal of pediatrics2025

Invasive Group A Streptococcus infections in children during the post-pandemic period: results from a multicenter study in Italy.

Elena Chiappini, Marco Renni, Maia De Luca, Samantha Bosis, Silvia Garazzino, Laura Dotta, Raffaele Badolato, Federica Zallocco, Daniele Zama, Antonella Frassanitto and 14 more

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Italian journal of pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
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

24 authors.

Elena Chiappini *Infectious Diseases Unit, Meyer Children's Hospital IRCCS, Florence, Italy. elena.chiappini@unifi.it.ORCID http://orcid.org/0000-0002-1476-4752
Marco Renni *Postgraduate School of Pediatrics, Department of Health Sciences, University of Florence, Florence, Italy.
Maia De LucaInfectious Disease Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, 00165, Italy.
Samantha BosisFondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, SC Pediatria Pneumoinfettivologia, Milan, Italy.
Silvia GarazzinoPediatric Infectious Diseases Unit, Regina Margherita Children's Hospital, University of Turin, Turin, Italy.
Laura DottaDepartment of Pediatrics and "A. Nocivelli" Institute for Molecular Medicine, Department of Clinical and Experimental Sciences, ASST Spedali Civili of Brescia, University of Brescia, Brescia, Italy.
Raffaele BadolatoDepartment of Pediatrics and "A. Nocivelli" Institute for Molecular Medicine, Department of Clinical and Experimental Sciences, ASST Spedali Civili of Brescia, University of Brescia, Brescia, Italy.
Federica ZalloccoPediatric Infectious Disease Unit, Salesi Children Hospital, Azienda Ospedaliero Universitaria Delle Marche, Ancona, 60121, Italy.
Daniele ZamaDepartment of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
Antonella FrassanittoDepartment of Maternal, Infantile and Urological Sciences, Sapienza University of Rome, Rome, 00161, Italy.
Ilaria LiguoroDivision of Pediatrics, University Hospital of Udine, P.Zzale S. Maria Della Misericordia, Udine, 15. 33100, Italy.
Danilo BuonsensoDepartment of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Claudia ColombaDepartment of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties"G D'Alessandro", University of Palermo, Division of Paediatric Infectious Disease,"G. Di Cristina"Hospital, ARNAS Civico Di Cristina Benfratelli, PalermoPalermo, Italy.
Lorenza RomaniInfectious Disease Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, 00165, Italy.
Giulia LorenzettiInfectious Disease Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, 00165, Italy.
Federica CeroniUniversity of Milan, Milan, Italy.
Marco DeninaPediatric Infectious Diseases Unit, Regina Margherita Children's Hospital, University of Turin, Turin, Italy.
Nicolò MontiPostgraduate School of Pediatrics, Department of Health Sciences, University of Florence, Florence, Italy.
Catiuscia LisiDepartment of Health Sciences, University of Florence, Florence, Italy.
Luisa GalliInfectious Diseases Unit, Meyer Children's Hospital IRCCS, Florence, Italy.
Giangiacomo NicoliniPediatric Unit, San Martino Hospital, Belluno, 32100, Italy.
Guido Castelli GattinaraInstitute of Child Health, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Andrea Lo VecchioPediatric Infectious Disease Unit, Department of Translational Medical Sciences, University Hospital Policlinico Federico IIand, University of Naples Federico II, Naples, 80131, Italy.
Italian Society of Pediatric Infectious Diseases (SITIP)

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGroup A Streptococcus causes pediatric infections from mild to severe forms. Since late 2022, invasive cases have increased in Europe, possibly due to reduced post-COVID-19 immunity, more respiratory virus circulation, and emergence of virulent strains.

methodsA retrospective, multicenter observational study was conducted in twelve Italian pediatric Hospitals, including patients under 18 years hospitalized with invasive or severe Group A Streptococcus infection. Data were anonymized and analyzed to identify factors associated with Pediatric Intensive Care Unit (PICU) admission and discharge with sequelae or death.

resultsSeventy-five children with invasive or severe Group A Streptococcus infection were included; the majority (69.3%) were aged 2-10 years. Invasive Group A Streptococcus (iGAS) infection accounted for 58.7% (n = 44) and severe GAS (sGAS) infection for 41.3% (n = 31) of cases. Pediatric Intensive Care Unit admission was required in 45.3% (n = 34) of the entire patient cohort, in this subgroup viral coinfection (OR 5.684, p = 0.003), sepsis/septic shock (OR 4.406, p = 0.003), iGAS diagnosis (OR 4.153, p = 0.005), and procalcitonin (PCT) > 0.5 ng/mL (OR 7.105, p = 0.019) were independently associated with admission; the use of corticosteroids (OR 4.641, p = 0.003) and intravenous immunoglobulin (IVIG) (OR 16.667, p = 0.003) was also significantly more frequent. All patients received empirical β-lactam antibiotics; anti-toxin therapy was administered in 47 patients (62.7%): clindamycin (49.3%), linezolid (16.0%), and rifampicin (1.3%). Mechanical ventilation was required in 24.0% (n = 18), and 49.3% (n = 37) underwent surgery. Post-infectious sequelae occurred in 20.0% (n = 15) and four children died, mostly due to streptococcal toxic shock syndrome.

conclusionPediatric invasive group A streptococcal infection continues to pose a significant clinical challenge, with notable rates of morbidity and mortality, underscoring the need for early recognition and close monitoring of high-risk patients. A widespread use of adjunctive therapies was documented. Continued surveillance and robust clinical research are essential to optimize management strategies and improve patient outcomes.

Indexed as

COVID-19Streptococcal InfectionsStreptococcus pyogenesAdolescentChildChild, PreschoolFemaleHumansInfantIntensive Care Units, PediatricItalyMalePandemicsRetrospective StudiesChildrenGroup A Streptococcal InfectionsInvasive diseaseStreptococcus pyogenes

Identifiers

PMID41316382
PMCPMC12661756

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