title: Invasive group A streptococcal infection in children: clinical  manifestations and molecular characterization in a French  pediatric tertiary care center.
abstract: Invasive group A streptococcal (GAS) infections have a broad and evolving clinical spectrum, associated with various GAS genotypes and/or virulence factors that are only poorly described in children. We aimed to assess the clinical and molecular characteristics of invasive GAS infections in 28 children admitted from 2000 to 2007 at a large French pediatric tertiary care center. The GAS isolates were characterized molecularly by emm-typing and by the determination of the main virulence factors: speA, speB, speC, smeZ-1, ssa, sic, and silC. The median age of the children was 2.9 years. Osteoarticular infection (OAI) was the main clinical manifestation (n=15/28, 53%). emm-1 predominated (n=10/28), followed by emm-12, 3, and 4. No significant correlation was found between emm type and clinical manifestations, but emm-1 predominated in cases of OAI (n=7/15) and was associated with speA, speB, smeZ-1, and sic virulence factor genes. In this pediatric study, we describe a predominance of OAI associated with emm-1 GAS. Further larger international pediatric studies, including host immunity evaluation, are needed in order to better assess the pathogenesis of GAS infection in children.
authors.affiliation: Assistance Publique des Hôpitaux de Paris, Pédiatrie Générale, Pôle de Pédiatrie Aigue et Médecine Interne, Hôpital Robert Debré, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Henriet
authors.forename: F
authors.initials: F
authors.lastname: Kaguelidou
authors.forename: P
authors.initials: P
authors.lastname: Bidet
authors.forename: M
authors.initials: M
authors.lastname: Lorrot
authors.forename: A
authors.initials: A
authors.lastname: De Lauzanne
authors.forename: S
authors.initials: S
authors.lastname: Dauger
authors.forename: F
authors.initials: F
authors.lastname: Angoulvant
authors.forename: J-C
authors.initials: JC
authors.lastname: Mercier
authors.forename: C
authors.initials: C
authors.lastname: Alberti
authors.forename: E
authors.initials: E
authors.lastname: Bingen
authors.forename: A
authors.initials: A
authors.lastname: Faye
mesh_terms: D000942:Antigens, Bacterial / Q000235:genetics; D001425:Bacterial Outer Membrane Proteins / Q000235:genetics; D001426:Bacterial Proteins / Q000235:genetics; D001850:Bone Diseases, Infectious / Q000453:epidemiology / Q000382:microbiology; D002352:Carrier Proteins / Q000235:genetics; D002675:Child, Preschool; D015331:Cohort Studies; D005098:Exotoxins / Q000235:genetics; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D013290:Streptococcal Infections / Q000453:epidemiology / Q000382:microbiology*; D013297:Streptococcus pyogenes / Q000235:genetics*; D037521:Virulence Factors / Q000235:genetics
chemical_list: D000942:Antigens, Bacterial; D001425:Bacterial Outer Membrane Proteins; D001426:Bacterial Proteins; D002352:Carrier Proteins; D005098:Exotoxins; D037521:Virulence Factors; C014689:streptococcal M protein