Observational studyThe Pediatric infectious disease journal2026
The Severity and Characteristics of Pediatric Group A Streptococcal Meningitis in the Netherlands (2015-June 2024): Results From a Nationwide Multicenter Cohort Study.
Observational study in The Pediatric infectious disease journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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8 authors.
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Abstract
backgroundFrom 2022 onwards, several countries, including the Netherlands, reported a marked increase in invasive group A streptococcal (iGAS) infections. Therefore, we aimed to describe the clinical presentation, disease course, treatment and outcomes of group A streptococcus (GAS) meningitis, a rare but severe manifestation of GAS infection in pediatric patients.
methodsChildren with GAS meningitis were selected from the COPP-iGAS study, a national observational cohort study in children 0-17 years of age with in-hospital diagnosis of iGAS between 2015 and June 2024, conducted across 20 hospitals in the Netherlands, including all 7 academic centers with a pediatric intensive care unit.
resultsTwenty-seven children were included, of whom 41% (11/27) were younger than 5 years of age. Most patients presented during the first quarter of the year (n = 13/27, 48%). Admission to an intensive care unit occurred in 15/27 (56%) patients and 4/27 (15%) patients died. Detailed clinical data were available for 13/27 patients. Clinical course data could be evaluated for 12 of these patients. Among those 12 patients, almost two-thirds had a complicated disease course, mainly involving cardiorespiratory failure (4/12, 33%). All 12 patients received prolonged antibiotic therapy [median 43 days (IQR 14-61)], predominantly intravenously [median 42 days (IQR 14-50)]. Adjunctive therapy included corticosteroids (6/12, 50%), antiviral agents (3/12, 25%) and anticoagulants (3/12, 25%).
conclusionOur findings highlight that pediatric GAS meningitis is a severe condition characterized by high intensive care admission rates and substantial mortality. In the subgroup with detailed clinical data, complications were frequent and prolonged antibiotic treatment was common. Increased clinical awareness is warranted.
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