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Archives de pédiatrie
Volume 21, n° S2
pages 73-77 (novembre 2014)
Doi : 10.1016/S0929-693X(14)72264-X
Épidémiologie des infections invasives à streptocoques du groupe A dans les pays industrialisés : l’exemple des fasciites nécrosantes au Canada
Epidemiology of invasive group A streptococcal infections in developed countries : the Canadian experience with necrotizing fasciitis
 

Ph. Ovetchkine 1, , Ph. Bidet 2, 3, Ph. Minodier 4, J. Frère 5, E. Bingen 2

in memoriam

1 Service de maladies infectieuses, département de pédiatrie, CHU Sainte-Justine ; université de Montréal, 3175, chemin de la Côte-Sainte-Catherine, Montréal (QC) H3P 1H2, Canada 
2 Université Paris-Diderot, PRES Sorbonne-Paris-Cité, 46, rue Henri-Huchard, 75018 Paris, France 
3 Service de microbiologie, hôpital Robert-Debré (AP-HP), 48, boulevard Sérurier, 75019 Paris, France 
4 Service des urgences pédiatriques, hôpital Nord, Chemin-des-Bourrely, 13015 Marseille, France 
5 Service de pédiatrie-infectiologie, CHR de la Citadelle, boulevard du 12e de Ligne, 4000 Liège, Belgique 

*Auteur correspondant.
Résumé

Dans les pays industrialisés, les infections à streptocoque du groupe A étaient auparavant une source d’inquiétude du fait de la survenue de rhumatismes articulaires aigus et de leurs complications cardiaques. Cette entité qui tend à disparaître actuellement dans ces pays laisse la place à des infections invasives streptococcique de haute morbidité et mortalité, en particulier les fasciites nécrosantes, le plus souvent en association avec la varicelle. L’introduction du vaccin contre la varicelle, dans le calendrier régulier vaccinal québécois, s’est accompagnée d’une diminution signifi cative de la fréquence des cas de fasciites nécrosantes ou de cellulite. Cependant, nous n’avons pas pu mettre en évidence une diminution de la fréquence des infections invasives à streptocoque du groupe A, en raison d’une augmentation du nombre d’infections pleuro-pulmonaires et ostéo-articulaires.

The full text of this article is available in PDF format.
Summary

In industrialized countries, group A streptococcal infections were a source of concern, mainly due to the occurrence of rheumatic fever and its cardiac complications. At present, the incidence of rheumatic fever is decreasing in these countries, giving way to an increasing occurrence of invasive streptococcal group A infections with high level of morbidity and mortality. Streptococcal necrotizing fasciitis, a specifi c entity, emerged these last decades, often in association with chickenpox. The introduction of the varicella vaccine in the province of Quebec routine immunization program, was followed by a signifi cant decrease in the number of necrotizing fasciitis or other skin and soft-tissues infections in our pediatric population. However, in our experience at the CHU Sainte-Justine, this immunization program has not been helpful to reduce the overall incidence of invasive group A streptococcal infections. Conversely, an increase in the number of pleuro-pulmonary and osteo-articular infections was observed.

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