Flamant Alix, Demirjian Alicia, Lamagni Theresa, Toubiana Julie, Smeesters Pierre R, Cohen Jérémie F
Department of General Paediatrics and Paediatric Infectious Diseases, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France.
Department of Paediatric Infectious Diseases & Immunology, Evelina London Children's Hospital, London, UK; Antimicrobial Resistance and Healthcare-Associated Infections Division, UK Health Security Agency, London, UK.
Lancet Infect Dis. 2025 Jul 9. doi: 10.1016/S1473-3099(25)00343-3.
During the late phase of the COVID-19 pandemic, several high-income countries reported a surge in invasive group A streptococcal (iGAS) infections, with notable paediatric morbidity and mortality. This Review explores three potential drivers of this increase: the role of the COVID-19 pandemic and associated non-pharmaceutical interventions on group A streptococcus (GAS) circulation; the potential burden associated with other respiratory viruses such as influenza and respiratory syncytial virus; and the potential role of hypervirulent GAS clones and lineages. The resurgence of iGAS disease highlights the need for enhanced surveillance of both invasive and non-invasive GAS infections, as well as further research to clarify the role of immunity, viral interactions, and bacterial molecular epidemiology and its evolution. A comprehensive understanding of these dynamics is essential to inform future public health strategies aimed at mitigating the burden of iGAS disease.
在新冠疫情后期，几个高收入国家报告侵袭性A组链球菌（iGAS）感染激增，出现了显著的儿童发病和死亡情况。本综述探讨了这种增加的三个潜在驱动因素：新冠疫情及相关非药物干预措施对A组链球菌（GAS）传播的影响；与流感和呼吸道合胞病毒等其他呼吸道病毒相关的潜在负担；以及高毒力GAS克隆和谱系的潜在作用。iGAS疾病的卷土重来凸显了加强对侵袭性和非侵袭性GAS感染监测的必要性，以及进一步开展研究以阐明免疫、病毒相互作用、细菌分子流行病学及其演变所起作用的必要性。全面了解这些动态对于为旨在减轻iGAS疾病负担的未来公共卫生战略提供信息至关重要。
