Hazelhorst Elizabeth I, van Ewijk Catharina E, Wielders Cornelia C H, Te Wierik Margreet J M, Hahné Susan J M, de Melker Hester E, Knol Mirjam J, de Gier Brechje
Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
Epidemiol Infect. 2025 Mar 27;153:e57. doi: 10.1017/S0950268825000275.
In 2022, an increase in invasive group A streptococcal (iGAS) infections was observed in the Netherlands. A particular increase was seen among children; therefore, we aimed to assess risk factors for iGAS infection in children aged 6 months to 5 years. A prospective case-control study was conducted between February and May 2023. We approached parents of notified iGAS cases to complete a questionnaire on exposures during 4 weeks prior to disease onset. Controls were recruited via social media and matched to cases on sex and birthyear. Conditional logistic regression was performed to estimate odds ratios (OR) of exposures. For the analysis, we included 18 cases and 103 controls. Varicella prior to onset of iGAS disease was reported in two (11%) cases and one (1%) control (OR: 12.0, 95% CI: 1.1-139.0). Exposure to group A streptococcal (GAS)-like illnesses such as impetigo, pharyngitis, and scarlet fever was reported in 8 (44%) cases and 15 (15%) controls (OR: 7.1, 95% CI: 1.8-29.0). Our findings are in line with previous studies by identifying varicella as a risk factor for iGAS among young children and highlight the association with non-invasive GAS infections in the community as a possible source of transmission.
2022年，荷兰观察到侵袭性A组链球菌（iGAS）感染有所增加。在儿童中出现了特别明显的增长；因此，我们旨在评估6个月至5岁儿童iGAS感染的危险因素。2023年2月至5月进行了一项前瞻性病例对照研究。我们联系了已通报的iGAS病例的家长，让他们填写一份关于疾病发作前4周接触情况的问卷。对照组通过社交媒体招募，并在性别和出生年份上与病例匹配。进行条件逻辑回归以估计接触的比值比（OR）。在分析中，我们纳入了18例病例和103例对照。在2例（11%）病例和1例（1%）对照中报告了iGAS疾病发作前有水痘病史（OR：12.0，95%CI：1.1-139.0）。8例（44%）病例和15例（15%）对照报告接触过A组链球菌（GAS）相关疾病，如脓疱病、咽炎和猩红热（OR：7.1，95%CI：1.8-29.0）。我们的研究结果与之前的研究一致，将水痘确定为幼儿iGAS的一个危险因素，并强调与社区中非侵袭性GAS感染的关联可能是传播源。
