Poster Presentation Lancefield International Symposium for Streptococci and Streptococcal Diseases 2025

Background and Objectives

We recently treated an increased number of patients with GAS disease. Treatment failures and relapses among streptococcal pharyngitis patients were frequently reported during the same period. We analyzed the diagnostic testing results to understand the changes in rates of noninvasive and invasive GAS (iGAS) disease.

Design/Methods

Nationwide Children’s Hospital (NCH) serves to an estimated pediatric population of 300,000 children. All patients with positive tests during the study period of January 1, 2022, and June 30, 2023, were included.

Results

28,470 positive GAS test results were identified. The majority were pharyngeal swabs identified in fall 2022 and before the surge of observed invasive disease. The estimated rate of iGAS was 14.6 per 100,000 pediatric population (Table 1). 32% of the patients had more than one positive result within an 8-week period of each other. 13.6% of iGAS patients had preceding or co-infection with influenza. Only 10 isolates from iGAS had emm typing done. Of these tested, five belonged to emm 1, two belonged to emm 77, two belonged to emm 12 and one was emm 66.

Conclusion(s)

The number of positive tests increased before the surge of iGAS disease suggesting existing spread within the community. Increase in iGAS infections were significant. Reasons for clinical failures or symptomatic relapses in appropriately treated patients remain unclear bringing the possibility of utilizing throat cultures to appropriately identify recurrent infections and aid in molecular epidemiologic and antimicrobial susceptibility testing.

Table 1. GAS infections and complications