Effect of underlying immune compromise on the manifestations and outcomes of group A streptococcal bacteremia - 18/04/17
Summary |
Background |
Group A streptococcal bloodstream infection is the most common presentation of invasive group A streptococcal disease. We sought to determine the impact of immunosuppression on severity of disease and clinical outcomes.
Methods |
This retrospective review of 148 patients with at least one positive blood culture for Streptococcus pyogenes from 1/2003 to 3/2013 compared immunocompromised patients with those with no immunocompromise in regards to development of severe complications and mortality.
Results |
Twenty-five patients (17%) were immunocompromised; 123 were not. Skin and soft tissue infection occurred in 60% of immunocompromised vs. 38% of non-immunocompromised patients, p = .04. Necrotizing fasciitis and septic shock were significantly more common in immunocompromised patients, p < .0001 and .028, respectively. Mortality at 30 days was 32% in immunocompromised patients vs. 16% in non-immunocompromised patients, p = .05.
Conclusion |
Patients who are immunocompromised are more likely to develop necrotizing fasciitis and septic shock as complications of group A streptococcal bacteremia and have a higher mortality rate than patients who are not immunocompromised.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Severity of disease and outcomes of group A streptococcal bacteremia were compared among 25 patients who were immune compromised and 123 who were not immune compromised. |
• | Group A streptococcal bacteremia is associated with high mortality in immunocompromised hosts. |
• | Necrotizing fasciitis and septic shock are more likely among immunocompromised patients. |
Keywords : Streptococcus pyogenes, Group A Streptococcus, Bacteremia, Necrotizing fasciitis, Toxic shock syndrome, Immunosuppression
Plan
Vol 74 - N° 5
P. 450-455 - mai 2017 Retour au numéro
Article précédent
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