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. 2025 Sep;31(9):1698-1707.
doi: 10.3201/eid3109.250245.

Severe Group A Streptococcus Infection among Children, France, 2022-2024

Montserrat Sierra Colomina, Alix Flamant, Guillaume Le Balle, Jérémie F Cohen, Lionel Berthomieu, Stéphane Leteurtre, Yves Gillet, Etienne Javouhey, Stéphane Bechet, Corinne Levy, Robert Cohen, Agnès Ferroni, Damien Dubois, Miguel Angel Hernandez Martinez, Céline Plainvert, Asmaa Tazi; ISAI Study Group,; Camille Brehin; ISAI Study Group
Collaborators

Severe Group A Streptococcus Infection among Children, France, 2022-2024

Montserrat Sierra Colomina et al. Emerg Infect Dis. 2025 Sep.

Abstract

Group A Streptococcus infections have increased in Europe since September 2022. The French Pediatric Intensive Care and French Pediatric Infectious Diseases expert groups conducted a retrospective and prospective study of children who had severe group A Streptococcus infections during September 1, 2022-April 1, 2024, across 34 hospitals in France. A total of 402 pediatric patients (median age 4 [interquartile range 2-7.5] years; 42% girls, 58% boys) were enrolled. Cases were characterized by a low proportion of severe skin and soft tissue infections (16%), predominance of severe upper and lower respiratory tract infections (55%), and a 3.5% case-fatality rate. In multivariate analysis, hydrocortisone, corticosteroid, and vasopressor therapies were significantly associated with major sequelae or death. Molecular analysis revealed emm1 (73.0%) and emm12 (10.8%) strains; the M1UK clone represented 50% of emm1 strains. Clinicians, researchers, and public health authorities must collaborate to mitigate the effects of GAS on child health.

Keywords: France; GAS; Streptococcus pyogenes; bacteria; group A streptococcus; invasive infection; pediatrics; respiratory infections; streptococci.

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Figures

Figure 1
Figure 1
Trends in the number of hospital admissions for severe group A Streptococcus infection among 402 children, by month, France, 2022–2024.
Figure 2
Figure 2
Severe group A Streptococcus infection distribution in 402 children by age, France, 2022–2024.
Figure 3
Figure 3
Distribution of severe group A Streptococcus infection in 402 children, by type of infection and age, France, 2022–2024. ENT, ear-nose-throat.
See this image and copyright information in PMC

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