Invasive Group A Streptococcal Disease in a Spanish County Hospital
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?
Descripción general del estudio
Estado
Descripción detallada
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.
Tipo de estudio
Inscripción (Actual)
Contactos y Ubicaciones
Ubicaciones de estudio
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Barcelona
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Sant Pere de Ribes, Barcelona, España, 08810
- Hospital Residència Sant Camil
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Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
- Niño
- Adulto
- Adulto Mayor
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Método de muestreo
Población de estudio
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.
Descripción
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
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Modelos observacionales: COHORT
- Perspectivas temporales: RETROSPECTIVE
Cohortes e Intervenciones
Grupo / Cohorte |
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2018-2024 cohort
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2008-2012 historical cohort
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¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Periodo de tiempo |
|---|---|
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Annual incidence of invasive Streptococcus pyogenes disease
Periodo de tiempo: Each calendar year from 2018 to 2024
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Each calendar year from 2018 to 2024
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Colaboradores e Investigadores
Patrocinador
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio (Actual)
Finalización primaria (Actual)
Finalización del estudio (Actual)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Actual)
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
- Enfermedades musculoesqueléticas
- Procesos Patológicos
- Infecciones
- Septicemia
- Síndrome de Respuesta Inflamatoria Sistémica
- Inflamación
- Infecciones por bacterias grampositivas
- Infecciones bacterianas
- Infecciones bacterianas y micosis
- Condiciones Patológicas, Signos y Síntomas
- Fascitis
- Bacteriemia
- Infecciones estreptocócicas
- Fascitis Necrotizante
Otros números de identificación del estudio
- CSAPG-99
Plan de datos de participantes individuales (IPD)
¿Planea compartir datos de participantes individuales (IPD)?
Descripción del plan IPD
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).
Marco de tiempo para compartir IPD
After publication of main results of the study.
Criterios de acceso compartido de IPD
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.
Tipo de información de apoyo para compartir IPD
- PROTOCOLO DE ESTUDIO
Información sobre medicamentos y dispositivos, documentos del estudio
Estudia un producto farmacéutico regulado por la FDA de EE. UU.
Estudia un producto de dispositivo regulado por la FDA de EE. UU.
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