Surveillance of noninvasive group A Streptococcus infections in French ambulatory pediatrics before and during the COVID-19 pandemic: a prospective multicenter study from 2018-2022

Objectives: We evaluated the burden of noninvasive group A Streptococcus (GAS) infections in ambulatory pediatrics before and during the COVID-19 pandemic in France.Methods: We analyzed data from a national network of ambulatory pediatricians between 2018 and 2022. Clinicians evaluating children & LE;15 years old for tonsillopharyngitis, perianal infections, parony-chia/blistering dactylitis, and scarlet fever were invited to perform a rapid antigen detection test (RADT) for GAS. Monthly incidence of noninvasive GAS infections per 10,0 0 0 visits was modeled using time se-ries analysis, considering two breakpoints: March 2020 (first national lockdown) and March 2022 (end of mandatory mask-wearing in schools).Results: Over the study period, 125 pediatricians recorded 271,084 infectious episodes. GAS-related ill-nesses represented 4.3% of all infections. In March 2020, the incidence of GAS diseases decreased by 84.5% ( P < 0.001), with no significant trend until March 2022. After March 2022, the incidence signifi-cantly increased ( + 23.8% per month, P < 0.001), with similar patterns across all monitored GAS-related diseases.Conclusion: By using routine clinical data and RADTs, we have monitored changes in the incidence of noninvasive GAS infections in ambulatory pediatrics. COVID-19 mitigation measures have had a major impact on the epidemiology of noninvasive GAS infections, but their relaxation was followed by a surge above baseline levels.& COPY; 2023 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )