Department of Cardiology, Zealand University Hospital, Roskilde, Denmark.
Department of Cardiology, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark.
Infection. 2023 Oct;51(5):1513-1522. doi: 10.1007/s15010-023-02025-8. Epub 2023 Mar 24.
Streptococcal bloodstream infections (BSIs) are common, yet prognostic factors are poorly investigated. We aimed to investigate the mortality according to streptococcal species and seasonal variation.
Patients with streptococcal BSIs from 2008 to 2017 in the Capital Region of Denmark were investigated, and data were crosslinked with nationwide registers for the identification of comorbidities. A multivariable logistic regression analysis was performed to assess mortality according to streptococcal species and season of infection.
Among 6095 patients with a streptococcal BSI (mean age 68.1 years), the 30-day mortality was 16.1% and the one-year mortality was 31.5%. With S. pneumoniae as a reference, S. vestibularis was associated with a higher adjusted mortality both within 30 days (odds ratio (OR) 2.89 [95% confidence interval (CI) 1.20-6.95]) and one year (OR 4.09 [95% CI 1.70-9.48]). One-year mortality was also higher in S. thermophilus, S. constellatus, S. parasanguinis, S. salivarius, S. anginosus, and S. mitis/oralis. However, S. mutans was associated with a lower one-year mortality OR 0.44 [95% CI 0.20-0.97], while S. gallolyticus was associated with both a lower 30-day (OR 0.42 [95% CI 0.26-0.67]) and one-year mortality (OR 0.66 [95% CI 0.48-0.93]). Furthermore, with infection in the summer as a reference, patients infected in the winter and autumn had a higher association with 30-day mortality.
The mortality in patients with streptococcal BSI was associated with streptococcal species. Further, patients with streptococcal BSIs infected in the autumn and winter had a higher risk of death within 30 days, compared with patients infected in the summer.
链球菌血流感染（BSI）较为常见，但预后因素研究甚少。本研究旨在调查不同链球菌种及季节变化对死亡率的影响。
本研究纳入了 2008 年至 2017 年丹麦首都地区链球菌 BSI 患者，通过全国性登记系统交叉链接以明确合并症。采用多变量逻辑回归分析评估不同链球菌种和感染季节与死亡率的相关性。
在 6095 例链球菌 BSI 患者中（平均年龄 68.1 岁），30 天死亡率为 16.1%，1 年死亡率为 31.5%。以肺炎链球菌为参照，前庭链球菌感染 30 天（优势比 [OR] 2.89 [95%置信区间 1.20-6.95]）和 1 年（OR 4.09 [95%置信区间 1.70-9.48]）时的死亡率均更高。发热链球菌、星座链球菌、副血链球菌、唾液链球菌、咽峡炎链球菌和缓症链球菌/变异链球菌感染患者 1 年死亡率也较高。然而，变形链球菌感染患者 1 年死亡率较低（OR 0.44 [95%置信区间 0.20-0.97]），而牛链球菌感染患者 30 天（OR 0.42 [95%置信区间 0.26-0.67]）和 1 年（OR 0.66 [95%置信区间 0.48-0.93]）死亡率均较低。此外，以夏季感染为参照，冬季和秋季感染患者 30 天死亡率更高。
链球菌 BSI 患者的死亡率与链球菌种有关。此外，与夏季感染患者相比，秋冬季节感染链球菌的患者 30 天内死亡风险更高。
