Coinfections in hospitalized patients with severe fever with thrombocytopenia syndrome: A retrospective study

Abstract

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne disease with a high case fatality rate. Few studies have been performed on bacterial or fungal coinfections or the effect of antibiotic therapy. A retrospective, observational study was performed to assess the prevalence of bacterial and fungal coinfections in patients hospitalized for SFTSV infection. The most commonly involved microorganisms and the effect of antimicrobial therapy were determined by the site and source of infection. A total of 1201 patients hospitalized with SFTSV infection were included; 359 (29.9%) had microbiologically confirmed infections, comprised of 292 with community-acquired infections (CAIs) and 67 with healthcare-associated infections (HAIs). Death was independently associated with HAIs, with a more significant effect than that observed for CAIs. For bacterial infections, only those acquired in hospitals were associated with fatal outcomes, while fungal infection, whether acquired in hospital or community, was related to an increased risk of fatal outcomes. The infections in the respiratory tract and bloodstream were associated with a higher risk of death than that in the urinary tract. Both antibiotic and antifungal treatments were associated with improved survival for CAIs, while for HAIs, only antibiotic therapy was related to improved survival, and no effect from antifungal therapy was observed. Early administration of

Fibrinogen-to-prealbumin and C-reactive protein-to-prealbumin ratios as prognostic indicators in severe fever with thrombocytopenia syndrome

“…Additionally, the levels of MONO and eGFR were notably lower in the death group compared to the survival group. These findings suggest that patients in the death group experienced an earlier and more pronounced onset of the multiple organ dysfunction period compared to those in the survival group, a pattern consistent with findings from several prior studies ( Ge et al., 2022 ; Zhao et al., 2022 ; Liu et al., 2023 ; Song et al., 2023 ).…”

Pulmonary infection in patients with severe fever with thrombocytopenia syndrome: A multicentre observational study

“…5 Recent studies have reported the significantly high incidence of co-infections in SFTS, and these studies suggested consistently that respiratory infections were predominant and should be of sufficient concern. 6,7 SFTSV can cause cytokine storm and immunosuppression in severe cases. It has been demonstrated that fatal patients were more biased towards negative immune modulation, including significantly increased Th17 and decreased CD4 + T lymphocytes.…”

“…Recent studies have reported the significantly high incidence of co‐infections in SFTS, and these studies suggested consistently that respiratory infections were predominant and should be of sufficient concern 6,7 . SFTSV can cause cytokine storm and immunosuppression in severe cases.…”

Routine antimicrobial therapy for severe fever with thrombocytopenia syndrome does not improve prognosis: overlap weighting analysis using a nationwide inpatient database

“…A notable characteristic of SFTS is the substantial reduction in white blood cells, which has been linked to heightened susceptibility to co-infections, such as secondary bacterial infections [4]. These complications further exacerbate the clinical course of the disease, making the management of patients with SFTS particularly challenging.…”