Infectious Shock and Toxic Shock Syndrome Diagnoses in Hospitals, Colorado, USA

Smit, Michael; Nyquist, Ann‐Christine; Todd, James K.

doi:10.3201/eid1011.121547

Cited by 10 publications

(6 citation statements)

References 12 publications

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“…Although an International Classification of Diseases, Tenth Revision (ICD-10) code 20 exists for toxic shock syndrome, which may be caused by Staphylococcus aureus or GAS, no ICD-10 code specifies cases caused by GAS. In retrospective studies of STSS using hospital databases, besides capturing data on cases of GAS infections with an ICD code of toxic shock syndrome, investigators have attempted to improve the capture of data on STSS cases by including all patients with ICD codes for septic shock who also had at least 1 ICD code specific for an illness caused by GAS, categorizing these patients as “probable STSS cases.” 21,22 Recent studies have shown that the use of clinical data from electronic health records is a more objective and consistent method for tracking trends in septic shock and sepsis than relying on ICD codes from claims data. 23 -25 ABCs does not query ICD codes; surveillance officers complete case report forms using data from case medical records.…”

Section: Discussionmentioning

confidence: 99%

Challenges in Surveillance for Streptococcal Toxic Shock Syndrome: Active Bacterial Core Surveillance, United States, 2014-2017

Nanduri

Onukwube

Apostol³

et al. 2021

Public Health Rep

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Objectives Routine surveillance for streptococcal toxic shock syndrome (STSS), a severe manifestation of invasive group A Streptococcus (GAS) infections, likely underestimates its true incidence. The objective of our study was to evaluate routine identification of STSS in a national surveillance system for invasive GAS infections. Methods Active Bacterial Core surveillance (ABCs) conducts active population-based surveillance for invasive GAS disease in selected US counties in 10 states. We categorized invasive GAS cases with a diagnosis of STSS made by a physician as STSS–physician and cases that met the Council of State and Territorial Epidemiologists (CSTE) clinical criteria for STSS based on data in the medical record as STSS–CSTE. We evaluated agreement between the 2 methods for identifying STSS and compared the estimated national incidence of STSS when applying proportions of STSS–CSTE and STSS–physician among invasive GAS cases from this study with national invasive GAS estimates for 2017. Results During 2014-2017, of 7572 invasive GAS cases in ABCs, we identified 1094 (14.4%) as STSS–CSTE and 203 (2.7%) as STSS–physician, a 5.3-fold difference. Of 1094 STSS–CSTE cases, we identified only 132 (12.1%) as STSS–physician cases. Agreement between the 2 methods for identifying STSS was low (κ = 0.17; 95% CI, 0.14-0.19). Using ABCs data, we estimated 591 cases of STSS–physician and 3618 cases of STSS–CSTE occurred nationally in 2017. Conclusions We found a large difference in estimates of incidence of STSS when applying different surveillance methods and definitions. These results should help with better use of currently available surveillance data to estimate the incidence of STSS and to evaluate disease prevention efforts, in addition to guiding future surveillance efforts for STSS.

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Section: Discussionmentioning

confidence: 99%

Challenges in Surveillance for Streptococcal Toxic Shock Syndrome: Active Bacterial Core Surveillance, United States, 2014-2017

Nanduri

Onukwube

Apostol³

et al. 2021

Public Health Rep

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“…Prevention and control measures/strategies Early/improved diagnosis and treatment [15,19,69,[79][80][81][82][83][84][85][86][87] Infection control in hospitals/aged care settings [31,32,39,42,[88][89][90][91][92][93] Epidemiological investigations/improved surveillance systems [94][95][96][97][98][99] Improved quality of housing [15,20] Health education for healthcare providers and patients/community [15,45,85,[100][101][102][103][104] Screening of healthcare workers, asymptomatic cases and post-exposure prophylaxis for vulnerable groups [32] Hand hygiene [15,42] Avoid overcrowding [15] Reduced malnutrition and HIV infection [17] Improved GAS detection methods [105,106] Capacity building of healthcare workers [29] Suggested future preventio...…”

Section: Key Findings or Conclusion Risk Or Strategy Referencesmentioning

confidence: 99%

“…Primary preventive strategies are also necessary, since they prevent irreversible health conditions that may arise from complications due to GAS infections [118]. These strategies include epidemiological investigations and improved surveillance systems [94][95][96][97][98][99][111][112][113][114][115][116], improved quality of housing [18,20], good hand hygiene, which includes regular proper hand washing with soap and water, or use of alcohol hand rub [15,42], and avoiding overcrowding [15]. Improved personal hygiene is also key in controlling transmission, especially in boys, who tend to be more at-risk than girls [36].…”

Section: Prevention and Control Measures/strategiesmentioning

confidence: 99%

A Review of Streptococcus pyogenes: Public Health Risk Factors, Prevention and Control

2021

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Streptococcus pyogenes, (colloquially named “group A streptococcus” (GAS)), is a pathogen of public health significance, infecting 18.1 million people worldwide and resulting in 500,000 deaths each year. This review identified published articles on the risk factors and public health prevention and control strategies for mitigating GAS diseases. The pathogen causing GAS diseases is commonly transmitted via respiratory droplets, touching skin sores caused by GAS or through contact with contaminated material or equipment. Foodborne transmission is also possible, although there is need for further research to quantify this route of infection. It was found that GAS diseases are highly prevalent in developing countries, and among indigenous populations and low socioeconomic areas in developed countries. Children, the immunocompromised and the elderly are at the greatest risk of S. pyogenes infections and the associated sequelae, with transmission rates being higher in schools, kindergartens, hospitals and residential care homes. This was attributed to overcrowding and the higher level of social contact in these settings. Prevention and control measures should target the improvement of living conditions, and personal and hand hygiene. Adherence to infection prevention and control practices should be emphasized in high-risk settings. Resource distribution by governments, especially in developed countries, should also be considered.

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“…8 Incidence of mTSS remains 1-2/100,000 menstruating women 15-44 years of age with teens showing a greater risk when ,19 years of age. [9][10][11][12] The US FDA recommends alternating tampon use with sanitary napkin use during menstrual periods, a practice thought to reduce the risk of getting TSS. 13 Epidemiologic evidence demonstrates that tampon wear time or change frequency does not increase risk of mTSS.…”

Section: Introductionmentioning

confidence: 99%

Impact of Advertising on Tampon Wear-time Practices

Woeller

Miller

Robertson-Smith

et al. 2015

Clin Med�Insights�Womens�Health

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OBJECTIVES(1) To determine whether advertising nighttime tampon use for up to eight hours was understood to be consistent with label recommendations and (2) to determine whether television and print advertising with this message affected tampon wear times in adults and teens.METHODS(1) A comprehension study (online advertising and follow-up questionnaire) among women aged 14–49 years (300 per group) who viewed either the test or a control advertising message; (2) Diary-based surveys of tampon wear times performed prior to (n = 292 adults, 18–49 years, 74 teens, 12–17 years) and after (n = 287 adults, 104 teens) the launch of national advertising.RESULTSSignificantly more test message viewers than controls stated tampons should be worn less than or equal to eight hours (93.6% vs. 88.6%, respectively, P = 0.049). A directionally higher percentage of test message viewers said they would use a pad if sleeping longer than eight hours (52% vs. 42% of controls). Among the women who used tampons longer than eight hours when sleeping, 52% reported they would wake up and change compared with 45% of controls. No significant difference between baseline and follow-up diary surveys was found among teens or adults in various measures of tampon wear time (mean wear times; usage intervals from less than two hours to more than 10 hours; percentage of tampons used for more than or equal to eight hours; frequency of wearing at least one tampon more than eight hours).CONCLUSIONSAdvertising nighttime tampon wear for up to eight hours effectively communicated label recommendations but did not alter tampon wear times. The informational intervention had limited impact on established habits.

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Infectious Shock and Toxic Shock Syndrome Diagnoses in Hospitals, Colorado, USA

Cited by 10 publications

References 12 publications

Challenges in Surveillance for Streptococcal Toxic Shock Syndrome: Active Bacterial Core Surveillance, United States, 2014-2017

Challenges in Surveillance for Streptococcal Toxic Shock Syndrome: Active Bacterial Core Surveillance, United States, 2014-2017

A Review of Streptococcus pyogenes: Public Health Risk Factors, Prevention and Control

Impact of Advertising on Tampon Wear-time Practices

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