Increased rates of invasive bacterial disease in late 2022

Abstract

Abstract Purpose: Invasive bacterial disease is associated with significant morbidity and mortality. In winter 2022, there was an apparent increased rate of invasive bacterial disease compared to preceding years. Methods: Cross-site retrospective analysis of the three Children’s Health Ireland (CHI) hospitals looking at children admitted between 1st October 2022 – 31st December 2022 (Q4) with community-acquired invasive bacterial disease, defined as an abscess in a normally sterile site in the head, neck and chest or isolation or PCR detection of Streptococcus pneumoniae, Neisseria meningitidis, Streptococcus pyogenes (Group A streptococcus), or Haemophilus influenzae from a normally sterile site. Case numbers were compared to Q4 in each of 2018 – 2021. Results: 82 children met the case definition in Q4 2022 vs 97 (Q4 2018 – 2021). In 2022, 42/82 (51%) were female, median age 3.75y (1.5-8.25y). Only 2 (2%) were immunosuppressed and 2 others (2%) had underlying neurodisabiltiy. Fifty (61%) were admitted on second or subsequent presentation to a healthcare setting. Fifty-six (68%) had an abscess in a sterile site. Bloodstream infection (positive blood culture or PCR: 24 (29%)) was the most common site of infection, followed by neck 22 (27%) and intracranial 12 (15%). Group A streptococcus (GAS) 27 (33%) was the most common organism isolated. Seven cases (9%) died in 2022 compared to 2 patients (2%) from 2018 – 2021 (p <0.05). More children had Paediatric Overall Performance Category (POPC) scores>1 in 2022 than 2018 – 2021 (p=0.003). Conclusion: Invasive bacterial diseases increased in Q4 2022 with higher morbidity and mortality than in the preceding 4 years. Group A streptococcal infection was the most significant organism in 2022.