Severe Group A Streptococcus Infection among Children, France, 2022-2024.

Group A Streptococcus infections have increased in Europe since September 2022. The French Pediatric Intensive Care and French Pediatric Infectious Diseases expert groups conducted a retrospective and prospective study of children who had severe group A Streptococcus infections during September 1, 2022-April 1, 2024, across 34 hospitals in France. A total of 402 pediatric patients (median age 4 [interquartile range 2-7.5] years; 42% girls, 58% boys) were enrolled. Cases were characterized by a low proportion of severe skin and soft tissue infections (16%), predominance of severe upper and lower respiratory tract infections (55%), and a 3.5% case-fatality rate. In multivariate analysis, hydrocortisone, corticosteroid, and vasopressor therapies were significantly associated with major sequelae or death. Molecular analysis revealed emm1 (73.0%) and emm12 (10.8%) strains; the M1UK clone represented 50% of emm1 strains. Clinicians, researchers, and public health authorities must collaborate to mitigate the effects of GAS on child health.