title: [Epidemiology of invasive group A streptococcal infections in developed countries : the Canadian experience with necrotizing fasciitis].
abstract: In industrialized countries, group A streptococcal infections were a source of concern, mainly due to the occurrence of rheumatic fever and its cardiac complications. At present, the incidence of rheumatic fever is decreasing in these countries, giving way to an increasing occurrence of invasive streptococcal group A infections with high level of morbidity and mortality. Streptococcal necrotizing fasciitis, a specific entity, emerged these last decades, often in association with chickenpox. The introduction of the varicella vaccine in the province of Quebec routine immunization program, was followed by a significant decrease in the number of necrotizing fasciitis or other skin and soft-tissues infections in our pediatric population. However, in our experience at the CHU Sainte-Justine, this immunization program has not been helpful to reduce the overall incidence of invasive group A streptococcal infections. Conversely, an increase in the number of pleuro-pulmonary and osteo-articular infections was observed.
authors.affiliation: Service de maladies infectieuses, département de pédiatrie, CHU Sainte-Justine ; université de Montréal, 3175, chemin de la Côte-Sainte-Catherine, Montréal (QC) H3P 1H2, Canada. Electronic address: philippe.ovetchkine@umontreal.ca.
authors.forename: Ph
authors.initials: P
authors.lastname: Ovetchkine
authors.affiliation: Université Paris-Diderot, PRES Sorbonne-Paris-Cité, 46, rue Henri-Huchard, 75018 Paris, France; Service de microbiologie, hôpital Robert-Debré (AP-HP), 48, boulevard Sérurier, 75019 Paris, France.
authors.forename: Ph
authors.initials: P
authors.lastname: Bidet
authors.affiliation: Service des urgences pédiatriques, hôpital Nord, Chemin-des-Bourrely, 13015 Marseille, France.
authors.forename: Ph
authors.initials: P
authors.lastname: Minodier
authors.affiliation: Service de pédiatrie-infectiologie, CHR de la Citadelle, boulevard du 12(e) de Ligne, 4000 Liège, Belgique.
authors.forename: J
authors.initials: J
authors.lastname: Frère
authors.affiliation: Université Paris-Diderot, PRES Sorbonne-Paris-Cité, 46, rue Henri-Huchard, 75018 Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Bingen
mesh_terms: D002170:Canada / Q000453:epidemiology; D002644:Chickenpox / Q000453:epidemiology; D019433:Chickenpox Vaccine; D019049:Developed Countries; D019115:Fasciitis, Necrotizing / Q000453:epidemiology / Q000382:microbiology; D005838:Genotype; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D017192:Skin Diseases, Bacterial / Q000453:epidemiology / Q000382:microbiology; D018461:Soft Tissue Infections / Q000453:epidemiology / Q000382:microbiology; D013290:Streptococcal Infections / Q000453:epidemiology*; D013297:Streptococcus pyogenes / Q000235:genetics
chemical_list: D019433:Chickenpox Vaccine