{"title":"不同β-溶血性链球菌引起的链球菌中毒性休克综合征的特征:单中心回顾性研究","authors":"Makoto Inada, Noriko Iwamoto, Hidetoshi Nomoto, Shinya Tsuzuki, Norihiko Takemoto, Noriko Fuwa, Ataru Moriya, Norio Ohmagari","doi":"10.1093/ofid/ofae486","DOIUrl":null,"url":null,"abstract":"Background Streptococcal toxic shock syndrome (STSS) is a life-threatening condition caused by beta-hemolytic streptococci (BHS). Streptococcus pyogenes is the main causative agent of this disease; other BHS such as S. agalactiae or S. dysgalactiae could also cause STSS. However, the clinical characteristics of STSS caused by other types of BHS remain poorly understood. In this study, we evaluated the likelihood of STSS development in various streptococcal species. Methods We conducted a retrospective observational study using adult medical records of patients with invasive BHS in a tertiary care institution from 2002–2022 and classified them into STSS or non-STSS groups. Multivariable analysis of bacterial species adjusted for age and diabetes mellitus was conducted. S. pyogenes cases were propensity-matched (1:4) to non-pyogenes BHS cases. Results A total of 43 STSS and 285 non-STSS cases were identified. S. pyogenes, S. agalactiae, and S. dysgalactiae accounted for 17, 13, and 13 STSS cases, respectively. The crude mortality of STSS was approximately 35% in all groups. A multivariable analysis suggested that STSS was less frequent in S. agalactiae and S. dysgalactiae cases with odds ratio 0.24 (95% confident interval [CI]: 0.10–0.54, p<0.001) and 0.23 (95% CI: 0.10–0.55, p<0.001), respectively. Propensity score matching showed that S. pyogenes caused STSS more frequently than other BHS cases with an odds ratio of 3.28 (95% CI: 1.21–8.77, p=0.010). Conclusions This study described and compared the clinical characteristics of STSS caused by different BHS. We demonstrated that S. pyogenes caused STSS more often than other BHS.","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.8000,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Characteristics of Streptococcal Toxic Shock Syndrome Caused by Different Beta-Hemolytic Streptococci Species: A Single-Center Retrospective Study\",\"authors\":\"Makoto Inada, Noriko Iwamoto, Hidetoshi Nomoto, Shinya Tsuzuki, Norihiko Takemoto, Noriko Fuwa, Ataru Moriya, Norio Ohmagari\",\"doi\":\"10.1093/ofid/ofae486\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background Streptococcal toxic shock syndrome (STSS) is a life-threatening condition caused by beta-hemolytic streptococci (BHS). Streptococcus pyogenes is the main causative agent of this disease; other BHS such as S. agalactiae or S. dysgalactiae could also cause STSS. However, the clinical characteristics of STSS caused by other types of BHS remain poorly understood. In this study, we evaluated the likelihood of STSS development in various streptococcal species. Methods We conducted a retrospective observational study using adult medical records of patients with invasive BHS in a tertiary care institution from 2002–2022 and classified them into STSS or non-STSS groups. Multivariable analysis of bacterial species adjusted for age and diabetes mellitus was conducted. S. pyogenes cases were propensity-matched (1:4) to non-pyogenes BHS cases. Results A total of 43 STSS and 285 non-STSS cases were identified. S. pyogenes, S. agalactiae, and S. dysgalactiae accounted for 17, 13, and 13 STSS cases, respectively. The crude mortality of STSS was approximately 35% in all groups. A multivariable analysis suggested that STSS was less frequent in S. agalactiae and S. dysgalactiae cases with odds ratio 0.24 (95% confident interval [CI]: 0.10–0.54, p<0.001) and 0.23 (95% CI: 0.10–0.55, p<0.001), respectively. Propensity score matching showed that S. pyogenes caused STSS more frequently than other BHS cases with an odds ratio of 3.28 (95% CI: 1.21–8.77, p=0.010). Conclusions This study described and compared the clinical characteristics of STSS caused by different BHS. We demonstrated that S. pyogenes caused STSS more often than other BHS.\",\"PeriodicalId\":19517,\"journal\":{\"name\":\"Open Forum Infectious Diseases\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2024-08-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Open Forum Infectious Diseases\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/ofid/ofae486\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Open Forum Infectious Diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ofid/ofae486","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
Characteristics of Streptococcal Toxic Shock Syndrome Caused by Different Beta-Hemolytic Streptococci Species: A Single-Center Retrospective Study
Background Streptococcal toxic shock syndrome (STSS) is a life-threatening condition caused by beta-hemolytic streptococci (BHS). Streptococcus pyogenes is the main causative agent of this disease; other BHS such as S. agalactiae or S. dysgalactiae could also cause STSS. However, the clinical characteristics of STSS caused by other types of BHS remain poorly understood. In this study, we evaluated the likelihood of STSS development in various streptococcal species. Methods We conducted a retrospective observational study using adult medical records of patients with invasive BHS in a tertiary care institution from 2002–2022 and classified them into STSS or non-STSS groups. Multivariable analysis of bacterial species adjusted for age and diabetes mellitus was conducted. S. pyogenes cases were propensity-matched (1:4) to non-pyogenes BHS cases. Results A total of 43 STSS and 285 non-STSS cases were identified. S. pyogenes, S. agalactiae, and S. dysgalactiae accounted for 17, 13, and 13 STSS cases, respectively. The crude mortality of STSS was approximately 35% in all groups. A multivariable analysis suggested that STSS was less frequent in S. agalactiae and S. dysgalactiae cases with odds ratio 0.24 (95% confident interval [CI]: 0.10–0.54, p<0.001) and 0.23 (95% CI: 0.10–0.55, p<0.001), respectively. Propensity score matching showed that S. pyogenes caused STSS more frequently than other BHS cases with an odds ratio of 3.28 (95% CI: 1.21–8.77, p=0.010). Conclusions This study described and compared the clinical characteristics of STSS caused by different BHS. We demonstrated that S. pyogenes caused STSS more often than other BHS.
期刊介绍:
Open Forum Infectious Diseases provides a global forum for the publication of clinical, translational, and basic research findings in a fully open access, online journal environment. The journal reflects the broad diversity of the field of infectious diseases, and focuses on the intersection of biomedical science and clinical practice, with a particular emphasis on knowledge that holds the potential to improve patient care in populations around the world. Fully peer-reviewed, OFID supports the international community of infectious diseases experts by providing a venue for articles that further the understanding of all aspects of infectious diseases.