Department of General Pediatrics and Pediatric Infectious Diseases, Hôpital Necker-Enfants malades, AP-HP, Université Paris Cité, Paris, France; Centre of Research in Epidemiology and Statistics (Inserm UMR 1153), Université Paris Cité, Paris, France.
Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Créteil, France; Pediatric Emergency Department, Hôpital Trousseau, AP-HP, Sorbonne Université, Paris, France; Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables (ECEVE, Inserm UMR S-1123), Université Paris Cité, Paris, France; Association Française de Pédiatrie Ambulatoire (AFPA), Paris, France.
Int J Infect Dis. 2023 Sep;134:135-141. doi: 10.1016/j.ijid.2023.06.003. Epub 2023 Jun 6.
We evaluated the burden of noninvasive group A Streptococcus (GAS) infections in ambulatory pediatrics before and during the COVID-19 pandemic in France.
We analyzed data from a national network of ambulatory pediatricians between 2018 and 2022. Clinicians evaluating children ≤15 years old for tonsillopharyngitis, perianal infections, paronychia/blistering dactylitis, and scarlet fever were invited to perform a rapid antigen detection test (RADT) for GAS. Monthly incidence of noninvasive GAS infections per 10,000 visits was modeled using time series analysis, considering two breakpoints: March 2020 (first national lockdown) and March 2022 (end of mandatory mask-wearing in schools).
Over the study period, 125 pediatricians recorded 271,084 infectious episodes. GAS-related illnesses represented 4.3% of all infections. In March 2020, the incidence of GAS diseases decreased by 84.5% (P <0.001), with no significant trend until March 2022. After March 2022, the incidence significantly increased (+23.8% per month, P <0.001), with similar patterns across all monitored GAS-related diseases.
By using routine clinical data and RADTs, we have monitored changes in the incidence of noninvasive GAS infections in ambulatory pediatrics. COVID-19 mitigation measures have had a major impact on the epidemiology of noninvasive GAS infections, but their relaxation was followed by a surge above baseline levels.
我们评估了 COVID-19 大流行前后法国门诊儿科中无侵袭性 A 组链球菌（GAS）感染的负担。
我们分析了 2018 年至 2022 年期间一个全国性的门诊儿科医生网络的数据。评估 ≤15 岁儿童的扁桃体咽炎、肛周感染、甲周脓肿/水疱状指炎和猩红热的临床医生被邀请进行 GAS 的快速抗原检测（RADT）。使用时间序列分析，考虑两个断点，即 2020 年 3 月（第一次全国封锁）和 2022 年 3 月（学校强制戴口罩结束），对每 10000 次就诊中无侵袭性 GAS 感染的每月发病率进行建模。
在研究期间，125 名儿科医生记录了 271084 次感染发作。GAS 相关疾病占所有感染的 4.3%。2020 年 3 月，GAS 疾病的发病率下降了 84.5%（P <0.001），直到 2022 年 3 月没有明显的趋势。2022 年 3 月之后，发病率显著增加（每月增加 23.8%，P <0.001），所有监测到的 GAS 相关疾病均呈现相似的模式。
通过使用常规临床数据和 RADT，我们监测了门诊儿科中无侵袭性 GAS 感染发病率的变化。COVID-19 缓解措施对无侵袭性 GAS 感染的流行病学产生了重大影响，但放松措施后，发病率超过了基线水平。
