Inada Makoto, Iwamoto Noriko, Nomoto Hidetoshi, Tsuzuki Shinya, Takemoto Norihiko, Fuwa Noriko, Moriya Ataru, Ohmagari Norio
Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.
AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan.
Open Forum Infect Dis. 2024 Aug 27;11(9):ofae486. doi: 10.1093/ofid/ofae486. eCollection 2024 Sep.
Streptococcal toxic shock syndrome (STSS) is a life-threatening condition caused by beta-hemolytic streptococci (BHS). is the main causative agent of this disease; other BHS such as or 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.
We conducted a retrospective observational study using adult medical records of patients with invasive BHS in a tertiary care institution from 2002 to 2022 and classified them into STSS or non-STSS groups. Multivariable analysis of bacterial species adjusted for age and diabetes mellitus was conducted. cases were propensity-matched (1:4) to non-pyogenes BHS cases.
A total of 43 STSS and 285 non-STSS cases were identified. , , and 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 and cases with odds ratio 0.24 (95% confidence interval [CI], 0.10-0.54; < .001) and 0.23 (95% CI, .10-.55; < .001), respectively. Propensity score matching showed that caused STSS more frequently than other BHS cases with an odds ratio of 3.28 (95% CI 1.21-8.77; = .010).
This study described and compared the clinical characteristics of STSS caused by different BHS. We demonstrated that caused STSS more often than other BHS.
链球菌中毒性休克综合征（STSS）是由β溶血性链球菌（BHS）引起的一种危及生命的疾病。 是该疾病的主要病原体；其他BHS，如 或 也可导致STSS。然而，由其他类型BHS引起的STSS的临床特征仍知之甚少。在本研究中，我们评估了各种链球菌物种发生STSS的可能性。
我们使用2002年至2022年在一家三级医疗机构中侵袭性BHS患者的成人病历进行了一项回顾性观察研究，并将他们分为STSS组或非STSS组。对细菌种类进行了多变量分析，并对年龄和糖尿病进行了校正。 将病例与非化脓性BHS病例进行倾向匹配（1:4）。
共确定了43例STSS病例和285例非STSS病例。 、 和 分别占17例、13例和13例STSS病例。所有组中STSS的粗死亡率约为35%。多变量分析表明，在 病例和 病例中，STSS的发生率较低，优势比分别为0.24（95%置信区间[CI]，0.10 - 0.54； <.001）和0.23（95%CI，.10 -.55； <.001）。倾向得分匹配显示， 引起STSS的频率高于其他BHS病例，优势比为3.28（95%CI 1.21 - 8.77； =.010）。
本研究描述并比较了不同BHS引起的STSS的临床特征。我们证明， 引起STSS的频率高于其他BHS。
