Project Details

Emm Typing of iGAS in Children: Linking Strain Variability to Disease Severity and Outcomes

Dorine Borensztajn, MD, MSc, PhD

Summary

BACKGROUND: Invasive Group A Streptococcus (iGAS) infections, such as sepsis or streptococcal toxic shock syndrome, are associated with high morbidity and mortality, particularly among children. The burden of iGAS infections is alarmingly high, with at least 663,000 new cases and 163,000 deaths each year. Despite the availability of antibiotics, iGAS infections can progress rapidly to severe disease, with a large number of affected children requiring admission to the ICU or succumbing to the infection. This highlights the urgent need for improved preventive and therapeutic strategies. GAP: Current public health strategies lack precise tools for the early identification of high-risk iGAS strains, and there is limited data on emm types in pediatric iGAS, particularly regarding diagnosis, severity, and outcomes. This gap in knowledge hampers our ability to predict severe cases and to tailor interventions effectively. HYPOTHESIS: We hypothesize that emm-typing strains will identify high-risk serotypes linked to severe disease in children. Our aim is to characterize emm type distribution among severe pediatric iGAS cases. METHODS: This study will analyze stored GAS strains and epidemiological data from the European Pegasus cohort, a multicenter study, focusing on identifying high-risk emm types linked to severe outcomes, including mortality. With a projected sample of 200 isolates, the study is adequately powered to detect significant associations. RESULTS: Pending. IMPACT: Identifying of high-risk emm types has the potential to revolutionize public health strategies for iGAS by enabling targeted surveillance and prioritizing specific serotypes for vaccine development and outbreak control. Ultimately, this work aims to reduce the burden of severe iGAS disease in children. Website Link: www.pegasus-study.eu