Invasive group A streptococcal infections requiring paediatric intensive care in children and adolescents: a nationwide retrospective cohort study in Austria.

The most frequent initial symptoms were pleural empyema (51.4%), pneumonia (45.7%), sepsis (44.3%), and septic-shock (25.7%).

Co-infections (viral/bacterial) were documented in 55.7%.

Extracorporeal therapies were used in 10.0% overall, including extracorporeal membrane oxygenation and continuous renal replacement therapy.

During the 2022-2024 surge, iGAS presentations requiring paediatric intensive care units admission in Austria were predominantly respiratory, with high rates of organ support and notable mortality.