{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T12:10:22Z","timestamp":1793880622855,"version":"4.7.0"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100006389","name":"University of Geneva","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006389","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Clin Microbiol Infect Dis"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      During the winter season of 2022\u20132023, numerous countries experienced a surge in invasive\n                      <jats:italic>Streptococcus pyogenes<\/jats:italic>\n                      (iGAS) infections. The role of viral coinfections in the post-COVID surge has not been elucidated. We report nation-wide data describing clinical presentation, microbiological characteristics, and associations with viral infection in adults during this period.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multicenter retrospective cohort study was conducted across 10 hospitals in Switzerland, including adults (&gt;\u200916 years old) with iGAS infection from November 2022 to February 2023. Descriptive analysis was performed. A multivariable logistic regression model was fitted to assess the impact of viral coinfection. In addition, genetic analysis was performed in available isolates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 194 patients were included, with a median age of 50 years (interquartile range [IQR]: 37\u201369). 17\/194 (8.8%) were immunosuppressed and 40\/194 (20.6%) exhibited concomitant viral infections, predominantly Influenza A (21\/40, 53%). Illness severity was high: 65\/194 (33.5%) of cases necessitated admission to an intensive care unit (ICU), and the 30-day mortality was 4% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098). Among the available strains for genetic analysis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200948), heterogeneity was found although ST28-\n                      <jats:italic>emm<\/jats:italic>\n                      1 isolates (also known as M1UK) was predominant (22\/48).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The post-COVID iGAS surge in Switzerland was associated with high levels of morbidity and mortality in immunocompetent adults. M1UK was predominant within the iGAS strains circulating in Switzerland during the study period and viral coinfection was a predictor for ICU admission and mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10096-025-05229-y","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T13:41:13Z","timestamp":1754401273000},"page":"2677-2684","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Role of viral coinfection in post-pandemic invasive Group A streptococcal infections in adults, a nation-wide cohort study (iGASWISS)"],"prefix":"10.1007","volume":"44","author":[{"given":"S.","family":"Musumeci","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"MacPhail","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Weisser Rohacek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Erba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Goldenberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Lang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Colin-Benoit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. L.","family":"Leib","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Sendi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Chuard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Erard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Fournier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Cobuccio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Tagini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Bertelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Senn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Sommerstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Bl\u00e4ttler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Vieira Gomes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Moraz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Emonet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Strahm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Kohler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. N.","family":"Seiffert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Herzog","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Vuichard Gysin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. D.","family":"Brugger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Nolte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Egli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Weller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. M.","family":"Andrianaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. S.","family":"Zinkernagel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D-L","family":"Vu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Uribe Caparros","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Laurie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Gaia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Lazarevic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Fran\u00e7ois","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Schrenzel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,5]]},"reference":[{"key":"5229_CR1","doi-asserted-by":"publisher","first-page":"100873","DOI":"10.1016\/j.lanwpc.2023.100873","volume":"41","author":"YN Abo","year":"2023","unstructured":"Abo YN, Oliver J, McMinn A et al (2023) Increase in invasive group A Streptococcal disease among Australian children coinciding with Northern hemisphere surges. Lancet Reg Health West Pac 41:100873. https:\/\/doi.org\/10.1016\/j.lanwpc.2023.100873","journal-title":"Lancet Reg Health West Pac"},{"issue":"3","key":"5229_CR2","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1001\/jama.1993.03500030088038","volume":"269","author":"Defining the Group A Atreptococcal Toxic Shock Syndrome","year":"1993","unstructured":"Defining the Group A Atreptococcal Toxic Shock Syndrome (1993) Rationale and consensus definition. The working group on severe Streptococcal infections. JAMA 269(3):390\u2013391","journal-title":"JAMA"},{"key":"5229_CR3","unstructured":"ECDC (2022) December https:\/\/www.ecdc.europa.eu\/en\/news-events\/increase-invasive-group-streptococcal-infections-among-children-europe-including"},{"issue":"1","key":"5229_CR4","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2023.28.1.2200941","volume":"28","author":"B de Gier","year":"2023","unstructured":"de Gier B, Marchal N, de Beer-Schuurman I et al (2023) Increase in invasive group A streptococcal (Streptococcus pyogenes) infections (iGAS) in young children in the Netherlands, 2022. Euro Surveill 28(1):2200941. https:\/\/doi.org\/10.2807\/1560-7917.ES.2023.28.1.2200941","journal-title":"Euro Surveill"},{"key":"5229_CR5","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1016\/j.ijid.2023.06.003","volume":"134","author":"JF Cohen","year":"2023","unstructured":"Cohen JF, Rybak A, Werner A et al (2023) Surveillance of noninvasive group A Streptococcus infections in French ambulatory pediatrics before and during the COVID-19 pandemic: a prospective multicenter study from 2018\u20132022. Int J Infect Dis 134:135\u2013141. https:\/\/doi.org\/10.1016\/j.ijid.2023.06.003","journal-title":"Int J Infect Dis"},{"issue":"4","key":"5229_CR6","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1016\/j.ajic.2022.09.002","volume":"51","author":"R Amarsy","year":"2023","unstructured":"Amarsy R, Fournier S, Trystram D et al (2023) Decrease of hospital- and community-acquired bloodstream infections due to Streptococcus pneumoniae and Streptococcus pyogenes during the first year of the COVID-19 pandemic: a time-series analysis in Paris region. Am J Infect Control 51(4):475\u2013477. https:\/\/doi.org\/10.1016\/j.ajic.2022.09.002","journal-title":"Am J Infect Control"},{"issue":"7","key":"5229_CR7","doi-asserted-by":"publisher","first-page":"3057","DOI":"10.1007\/s00431-023-04967-5","volume":"182","author":"E Cobo-V\u00e1zquez","year":"2023","unstructured":"Cobo-V\u00e1zquez E, Aguilera-Alonso D, Carbayo T et al (2023) Epidemiology and clinical features of Streptococcus pyogenes bloodstream infections in children in Madrid, Spain. Eur J Pediatr 182(7):3057\u20133062. https:\/\/doi.org\/10.1007\/s00431-023-04967-5","journal-title":"Eur J Pediatr"},{"issue":"10","key":"5229_CR8","doi-asserted-by":"publisher","first-page":"ofae572","DOI":"10.1093\/ofid\/ofae572","volume":"11","author":"G Epprecht","year":"2024","unstructured":"Epprecht G, Weller D, Hofmaenner DA et al (2024) Impact of the COVID-19 pandemic on group A Streptococcal necrotizing soft tissue infections: A retrospective cohort study. Open Forum Infect Dis 11(10):ofae572. https:\/\/doi.org\/10.1093\/ofid\/ofae572","journal-title":"Open Forum Infect Dis"},{"issue":"5","key":"5229_CR9","doi-asserted-by":"publisher","first-page":"ofad188","DOI":"10.1093\/ofid\/ofad188","volume":"10","author":"Y Lassoued","year":"2023","unstructured":"Lassoued Y, Assad Z, Ouldali N et al (2023) Unexpected increase in invasive group A Streptococcal infections in children after respiratory viruses outbreak in france: A 15-Year Time-Series analysis. Open Forum Infect Dis 10(5):ofad188. https:\/\/doi.org\/10.1093\/ofid\/ofad188","journal-title":"Open Forum Infect Dis"},{"issue":"6","key":"5229_CR10","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.18959","volume":"5","author":"A Rybak","year":"2022","unstructured":"Rybak A, Levy C, Angoulvant F et al (2022) Association of nonpharmaceutical interventions during the COVID-19 pandemic with invasive pneumococcal disease, pneumococcal carriage, and respiratory viral infections among children in France. JAMA Netw Open 5(6):e2218959. https:\/\/doi.org\/10.1001\/jamanetworkopen.2022.18959","journal-title":"JAMA Netw Open"},{"key":"5229_CR11","doi-asserted-by":"publisher","first-page":"342","DOI":"10.3389\/fmicb.2016.00342","volume":"7","author":"AL Herrera","year":"2016","unstructured":"Herrera AL, Huber VC, Chaussee MS (2016) The association between invasive group A streptococcal diseases and viral respiratory tract infections. Front Microbiol 7:342. https:\/\/doi.org\/10.3389\/fmicb.2016.00342","journal-title":"Front Microbiol"},{"issue":"1","key":"5229_CR12","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-023-04774-2","volume":"28","author":"A Orieux","year":"2024","unstructured":"Orieux A, Prevel R, Dumery M et al (2024) Invasive group A streptococcal infections requiring admission to ICU: a nationwide, multicenter, retrospective study (ISTRE study). Crit Care 28(1):4. https:\/\/doi.org\/10.1186\/s13054-023-04774-2","journal-title":"Crit Care"},{"issue":"7","key":"5229_CR13","doi-asserted-by":"publisher","first-page":"1018","DOI":"10.1086\/511989","volume":"195","author":"DM Morens","year":"2007","unstructured":"Morens DM, Fauci AS (2007) The 1918 influenza pandemic: insights for the 21st century. J Infect Dis 195(7):1018\u20131028. https:\/\/doi.org\/10.1086\/511989","journal-title":"J Infect Dis"},{"issue":"5","key":"5229_CR14","doi-asserted-by":"publisher","first-page":"19785","DOI":"10.2807\/ese.16.05.19785-en","volume":"16","author":"K Zakikhany","year":"2011","unstructured":"Zakikhany K, Degail MA, Lamagni T et al (2011) Increase in invasive Streptococcus pyogenes and Streptococcus pneumoniae infections in England, December 2010 to January 2011. Euro Surveill 16(5):19785","journal-title":"Euro Surveill"},{"issue":"7","key":"5229_CR15","doi-asserted-by":"publisher","first-page":"887","DOI":"10.1016\/j.cmi.2023.03.001","volume":"29","author":"A Alcolea-Medina","year":"2023","unstructured":"Alcolea-Medina A, Snell LB, Alder C et al (2023) The ongoing Streptococcus pyogenes (Group A Streptococcus) outbreak in London, United Kingdom, in December 2022: a molecular epidemiology study. Clin Microbiol Infect 29(7):887\u2013890. https:\/\/doi.org\/10.1016\/j.cmi.2023.03.001","journal-title":"Clin Microbiol Infect"},{"key":"5229_CR16","unstructured":"PIGS (Pediatric Infectious Disease Group of Switzerland) (2022). http:\/\/pigs.ch"},{"key":"5229_CR17","unstructured":"Cusini A (2023) Changes in the epidemiology of invasive infections with Group A streptococcus in time of the COVID-19 pandemic in Switzerland. Poster presented at: Joint Annual Meeting 2023| SSI| SSHH| SSTTM, Zurich, Switzerland"},{"issue":"1","key":"5229_CR18","doi-asserted-by":"publisher","first-page":"100004","DOI":"10.1016\/j.cmicom.2024.100004","volume":"1","author":"AM Andrianaki","year":"2024","unstructured":"Andrianaki AM, Andreoni F, Franz J et al (2024) Molecular epidemiology of invasive group A Streptococcal infections before and after the COVID-19 pandemic in Switzerland. CMI Commun 1(1):100004. https:\/\/doi.org\/10.1016\/j.cmicom.2024.100004","journal-title":"CMI Commun"},{"issue":"10","key":"5229_CR19","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1016\/S1473-3099(09)70178-1","volume":"9","author":"AC Steer","year":"2009","unstructured":"Steer AC, Law I, Matatolu L, Beall BW, Carapetis JR (2009) Global emm type distribution of group A streptococci: systematic review and implications for vaccine development. Lancet Infect Dis 9(10):611\u2013616. https:\/\/doi.org\/10.1016\/S1473-3099(09)70178-1","journal-title":"Lancet Infect Dis"},{"key":"5229_CR20","doi-asserted-by":"publisher","unstructured":"Vieira A, Wan Y, Ryan Y et al (2024) Rapid expansion and international spread of M1UK in the post-pandemic UK upsurge of Streptococcus pyogenes. Nat Commun 15(1):3916. https:\/\/doi.org\/10.1038\/s41467-024-47929-7","DOI":"10.1038\/s41467-024-47929-7"},{"issue":"11","key":"5229_CR21","doi-asserted-by":"publisher","first-page":"2390","DOI":"10.3201\/eid2911.230857","volume":"29","author":"A Bell\u00e9s-Bell\u00e9s","year":"2023","unstructured":"Bell\u00e9s-Bell\u00e9s A, Prim N, Mormeneo-Bayo S et al (2023) Changes in Group A Streptococcus Emm types associated with invasive infections in adults, spain, 2023. Emerg Infect Dis 29(11):2390\u20132392. https:\/\/doi.org\/10.3201\/eid2911.230857","journal-title":"Emerg Infect Dis"},{"issue":"7","key":"5229_CR22","doi-asserted-by":"publisher","first-page":"4104","DOI":"10.1128\/jvi.77.7.4104-4112.2003","volume":"77","author":"S Okamoto","year":"2003","unstructured":"Okamoto S, Kawabata S, Nakagawa I et al (2003) Influenza A virus-infected hosts boost an invasive type of Streptococcus pyogenes infection in mice. J Virol 77(7):4104\u20134112. https:\/\/doi.org\/10.1128\/jvi.77.7.4104-4112.2003","journal-title":"J Virol"}],"container-title":["European Journal of Clinical Microbiology &amp; Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10096-025-05229-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10096-025-05229-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10096-025-05229-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T12:35:57Z","timestamp":1763210157000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10096-025-05229-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,5]]},"references-count":22,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["5229"],"URL":"https:\/\/doi.org\/10.1007\/s10096-025-05229-y","relation":{},"ISSN":["0934-9723","1435-4373"],"issn-type":[{"value":"0934-9723","type":"print"},{"value":"1435-4373","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,5]]},"assertion":[{"value":"12 February 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 August 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}