We have previously reported (J Pediatr 1991;118:341-6) a significant increase beginning in the late 1980s in the incidence of invasive disease due to GABS in children admitted to our hospital. To determine subsequent trends in epidemiology, we have continued to prospectively monitor cases. We now review our experience during the 5 1/2 yrs (7/1/90-12/31/95) since our last report. During this period, 25 pts had GABS isolated from normally sterile sites. Seven (28%) had chicken pox. Four (16%) had chronic underlying conditions. Blood cultures were positive in 10 pts (40%). Infection was limited to the skin and subcutaneous tissues (with or without bacteremia) in 9 pts (36%). Other sites of infection included: lymph node (n=3), bone (3), joint (2), sinus (1), sinus and orbit (1), peritoneal fluid (1), pleural fluid(1) and CSF (1). One pt each had: endocarditis and cerebritis; necrotizing fasciitis (seen in 1995-no case had been seen in the 12 yrs prior); and toxic shock syndrome. One pt died (a one mo old with GABS sepsis and meningitis after RSV infection). Isolates from 23 pts were studied. Serotypes included: M1 (4); M3 (3); M6 (2); M12 (3); M22 (3); M-nontypable (7). Sixteen (70%) of the 23 strains did not produce serum opacity factor.

We also reviewed our yearly rates for 1983 through 1995 of invasive disease due to GABS. This data shows that invasive disease due to GABS continues to be seen in children more frequently than during the period prior to the late 1980s (ie, prior to the resurgence), however, the number of cases appears to be decreasing during the last few years.