{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T18:42:27Z","timestamp":1789670547924,"version":"4.0.1"},"reference-count":32,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T00:00:00Z","timestamp":1753920000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>An increase in invasive group A streptococcal (iGAS) infections among children under 15 years of age was reported in several countries between late 2022 and early 2023. This retrospective study aims to describe the epidemiology and clinical features of iGAS infections in children in Cyprus during the same period. Medical records of patients under 16 years old admitted with iGAS infection to the Archbishop Makarios Hospital, the only tertiary paediatric referral centre in Cyprus, between 1 January 2021 and 30 June 2024, were reviewed. Twenty-two cases were identified, of which twenty were classified as confirmed and two as probable. Half of the cases occurred in children aged 0\u20134 years, and 59% were recorded between December 2022 and April 2023. Scarlet fever was diagnosed in six children, five of whom developed pneumonia and empyema. Streptococcal toxic shock syndrome (STSS) was observed in five patients, resulting in two deaths and one case requiring prolonged extracorporeal membrane oxygenation (ECMO). The overall case fatality rate was 9.1%. Emm 1, belonging to the M1UK clone, was the predominant strain (66.6%). The findings underscore the severity of iGAS infections, particularly in younger children, and highlight the importance of timely diagnosis, appropriate management and continued epidemiological surveillance.<\/jats:p>","DOI":"10.3390\/microorganisms13081783","type":"journal-article","created":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T06:37:47Z","timestamp":1754030267000},"page":"1783","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Group A Streptococcal Invasive Infections Among Children in Cyprus"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0647-9967","authenticated-orcid":false,"given":"Maria","family":"Koliou","sequence":"first","affiliation":[{"name":"Medical School, University of Cyprus, Nicosia 2115, Cyprus"},{"name":"Archbishop Makarios Hospital, Nicosia 2012, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gavriella Ioannou","family":"Vassiliadou","sequence":"additional","affiliation":[{"name":"Medical School, University of Cyprus, Nicosia 2115, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athina","family":"Aristidou","sequence":"additional","affiliation":[{"name":"Archbishop Makarios Hospital, Nicosia 2012, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petros","family":"Ladas","sequence":"additional","affiliation":[{"name":"Medical School, University of Cyprus, Nicosia 2115, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Sergis","sequence":"additional","affiliation":[{"name":"Archbishop Makarios Hospital, Nicosia 2012, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Argyrou","sequence":"additional","affiliation":[{"name":"Archbishop Makarios Hospital, Nicosia 2012, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myria","family":"Charalambous","sequence":"additional","affiliation":[{"name":"Archbishop Makarios Hospital, Nicosia 2012, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markella","family":"Marcou","sequence":"additional","affiliation":[{"name":"Archbishop Makarios Hospital, Nicosia 2012, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Alexandrou","sequence":"additional","affiliation":[{"name":"Larnaca General Hospital, Larnaca 6043, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana","family":"Coelho","sequence":"additional","affiliation":[{"name":"UK Health Security Agency, London NW9 5EQ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Ryan","sequence":"additional","affiliation":[{"name":"UK Health Security Agency, London NW9 5EQ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7376-7160","authenticated-orcid":false,"given":"Androulla","family":"Efstratiou","sequence":"additional","affiliation":[{"name":"UK Health Security Agency, London NW9 5EQ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4591-8267","authenticated-orcid":false,"given":"Stella","family":"Mazeri","sequence":"additional","affiliation":[{"name":"Roslin Institute, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh EH25 9RG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1093\/clinids\/14.1.2","article-title":"Invasive Group A Streptococcus Infections","volume":"14","author":"Stevens","year":"1992","journal-title":"Clin. 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