Invasive Group A Streptococcal Disease in a Spanish County Hospital

November 6, 2026 updated by: Consorci Sanitari de l'Alt Penedès i Garraf

Invasive Streptococcus Pyogenes Disease: Epidemiology, Clinical Characteristics, Prognostic Factors, and Temporal Trends. A Retrospective Observational Study

The goal of this observational study is to describe how often invasive infections caused by Streptococcus pyogenes (group A streptococcus) occurred, how they presented, how they were treated, and how patients did, in patients of any age treated at Hospital Residència Sant Camil between 2018 and 2024. The main questions it aims to answer are:

  • What was the annual incidence of invasive group A streptococcal disease between 2018 and 2024, and did it increase after the COVID-19 pandemic?
  • What are the clinical characteristics, treatment, and outcomes of these patients, and how do they compare with the patients treated at the same hospital between 2008 and 2012?
  • Which clinical factors are associated with in-hospital death and with admission to the intensive care unit?

Study Overview

Status

Completed

Conditions

Detailed Description

Invasive group A streptococcal disease (iGAS) is a severe infection with high morbidity and mortality, including bacteremia, necrotizing fasciitis, streptococcal toxic shock syndrome, pneumonia, empyema, septic arthritis, and meningitis, with reported mortality of 10% to 20%. After a marked decrease in 2020 and 2021, surveillance systems reported a significant increase in cases in 2022 and 2023, which led to alerts from the World Health Organization, the European Centre for Disease Prevention and Control, and national authorities. Most evidence comes from national registries or tertiary hospitals, and data from Spanish county hospitals are scarce.

This single-center retrospective cohort study will include all episodes of iGAS diagnosed at Hospital Residència Sant Camil (Consorci Sanitari de l'Alt Penedès i Garraf) between January 1, 2018, and December 31, 2024. iGAS is defined as isolation of S. pyogenes from a normally sterile site, necrotizing fasciitis with isolation of S. pyogenes from deep tissue, or streptococcal toxic shock syndrome (CDC criteria) with microbiological isolation of S. pyogenes. Cases will be identified from all positive S. pyogenes isolates in the Microbiology Service records, and data will be collected from the electronic medical record into an electronic case report form (REDCap): demographics, comorbidities, site and acquisition of infection, bacteremia, toxic shock syndrome, polymicrobial infection, antibiotic treatment, ICU admission, and in-hospital mortality. The expected sample is 60 to 70 patients.

Annual incidence will be calculated using the reference population of the health area as the denominator. The 2018-2024 cohort will be compared with the historical 2008-2012 cohort from a previous study at the same hospital using the chi-square or Fisher's exact test and Student's t or Mann-Whitney U test. Bivariate analyses will assess the association between clinical characteristics and in-hospital mortality and ICU admission.

Study Type

Observational

Enrollment (Actual)

94

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Spain
    • Barcelona
      • Sant Pere de Ribes, Barcelona, Spain, 08810
        • Hospital Residència Sant Camil

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

All patients of any age with an episode of invasive Streptococcus pyogenes disease diagnosed between January 1, 2018, and December 31, 2024, and initially treated at Hospital Residència Sant Camil, identified from the Microbiology Service records.

Description

Inclusion Criteria:

  • Patients of any age and sex
  • Diagnosis of invasive S. pyogenes disease, defined by any of the following: isolation of S. pyogenes from a normally sterile sample; necrotizing fasciitis with isolation of S. pyogenes from deep tissue; or streptococcal toxic shock syndrome with microbiological isolation of S. pyogenes
  • Episode diagnosed between January 1, 2018, and December 31, 2024
  • Initial care of the episode at Hospital Residència Sant Camil
  • Sufficient clinical information available to obtain the study variables

Exclusion Criteria:

  • Episodes that do not meet the protocol definition of invasive S. pyogenes disease
  • Clinical or microbiological records with insufficient information to confirm the diagnosis or obtain the main study variables
  • Duplicate episodes corresponding to the same infectious process

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: COHORT
  • Time Perspectives: RETROSPECTIVE

Cohorts and Interventions

Group / Cohort
2018-2024 cohort
2008-2012 historical cohort

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Annual incidence of invasive Streptococcus pyogenes disease
Time Frame: Each calendar year from 2018 to 2024
Each calendar year from 2018 to 2024

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Consorci Sanitari de l'Alt Penedès i Garraf

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

September 17, 2026

Primary Completion (Actual)

October 1, 2026

Study Completion (Actual)

October 1, 2026

Study Registration Dates

First Submitted

November 6, 2026

First Submitted That Met QC Criteria

November 6, 2026

First Posted (Actual)

November 13, 2026

Study Record Updates

Last Update Posted (Actual)

November 13, 2026

Last Update Submitted That Met QC Criteria

November 6, 2026

Last Verified

November 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • CSAPG-99

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

IPD (without personal identification data) could be shared by requirement from other researchers after the end of the study, and only for research purposes and previous approval of promotor center of the study (CSAPG). Anyway, Spanish and European Union legal policy about data protection will strictly be followed (IPD will not be transferred outside European Union).

IPD Sharing Time Frame

After publication of main results of the study.

IPD Sharing Access Criteria

IPD will be shared only for scientific research purposes and following the Spanish and European Union normative law about data protection. The requirements will be directed to the IP of the study. The IP will evaluate the request to verify and evaluate the data that is requested and the purposes for which it is requested. Next, the IP will transfer the request to the promotor center the study for the final decision.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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