Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Risk factors and Predictors of Mortality in Streptococcal Necrotizing Soft-Tissue Infections: A Multicenter Prospective Study

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. Altered Immune Reconstitution in Allogeneic Stem Cell Transplant Recipients With Human Immunodeficiency Virus (HIV)

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Hepatic steatosis associated with exposure to elvitegravir and raltegravir

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Estimation of SARS-CoV-2 infection fatality rate by real-time antibody screening of blood donors

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Venous thromboembolism and major bleeding in patients with COVID-19: A nationwide population-based cohort study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Adjunctive hyperbaric oxygen treatment for necrotising soft-tissue infections: A systematic review and meta-analysis

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Non-invasive monitoring of carboxyhemoglobin during hyperbaric oxygen therapy

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Hyperbaric oxygen treatment is associated with a decrease in cytokine levels in patients with necrotizing soft-tissue infection

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Oxygen under tryk som behandling

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  • INFECT study group
Vis graf over relationer

BACKGROUND: Necrotizing soft-tissue infections (NSTI) are life-threatening conditions often caused by β-hemolytic streptococci, group A Streptococcus (GAS) in particular. Optimal treatment is contentious. The INFECT cohort includes the largest set of prospectively enrolled streptococcal NSTI cases to date.

METHODS: From the INFECT cohort of 409 adults admitted with NSTI to 5 clinical centers in Scandinavia, patients culture-positive for GAS or Streptococcus dysgalactiae (SD) were selected. Risk factors were identified by comparison with a cohort of nonnecrotizing streptococcal cellulitis. The impact of baseline factors and treatment on 90-day mortality was explored using Lasso regression. Whole-genome sequencing of bacterial isolates was used for emm typing and virulence gene profiling.

RESULTS: The 126 GAS NSTI cases and 27 cases caused by SD constituted 31% and 7% of the whole NSTI cohort, respectively. When comparing to nonnecrotizing streptococcal cellulitis, streptococcal NSTI was associated to blunt trauma, absence of preexisting skin lesions, and a lower body mass index. Septic shock was significantly more frequent in GAS (65%) compared to SD (41%) and polymicrobial, nonstreptococcal NSTI (46%). Age, male sex, septic shock, and no administration of intravenous immunoglobulin (IVIG) were among factors associated with 90-day mortality. Predominant emm types were emm1, emm3, and emm28 in GAS and stG62647 in SD.

CONCLUSIONS: Streptococcal NSTI was associated with several risk factors, including blunt trauma. Septic shock was more frequent in NSTI caused by GAS than in cases due to SD. Factors associated with mortality in GAS NSTI included age, septic shock, and no administration of IVIG.

OriginalsprogEngelsk
TidsskriftClinical infectious diseases : an official publication of the Infectious Diseases Society of America
Vol/bind72
Udgave nummer2
Sider (fra-til)293-300
Antal sider8
ISSN1058-4838
DOI
StatusUdgivet - 27 jan. 2021

Bibliografisk note

© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America.

ID: 59138154