Overdiagnosis of Asthma and Its Relationship to Body Mass Index

Mehta, Chitra; Migliore, Christina; Rezai, Fariborz; Patel, Lopa; Anandarangam, Thiruvengadam; Karetzky, Monroe

doi:10.1378/chest.130.6.1679

Cited by 40 publications

(9 citation statements)

References 26 publications

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“…Despite recent advances in medical care, invasive Group A Streptococcus-induced NF patients have high mortality rates (ranging from 18% to 34%) [32,33]. The reported rates of bacteremia with Group A streptococci range from 46 to 85% [34-36]. Our results showed that patients with Group A Streptococcus in blood cultures had significantly higher mortality rates when compared with patients negative for Group A Streptococcus .…”

Section: Discussionmentioning

confidence: 60%

The microbiological profile and presence of bloodstream infection influence mortality rates in necrotizing fasciitis

Chen

Hong

et al. 2011

Crit Care

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IntroductionNecrotizing fasciitis (NF) is a life threatening infectious disease with a high mortality rate. We carried out a microbiological characterization of the causative pathogens. We investigated the correlation of mortality in NF with bloodstream infection and with the presence of co-morbidities.MethodsIn this retrospective study, we analyzed 323 patients who presented with necrotizing fasciitis at two different institutions. Bloodstream infection (BSI) was defined as a positive blood culture result. The patients were categorized as survivors and non-survivors. Eleven clinically important variables which were statistically significant by univariate analysis were selected for multivariate regression analysis and a stepwise logistic regression model was developed to determine the association between BSI and mortality.ResultsUnivariate logistic regression analysis showed that patients with hypotension, heart disease, liver disease, presence of Vibrio spp. in wound cultures, presence of fungus in wound cultures, and presence of Streptococcus group A, Aeromonas spp. or Vibrio spp. in blood cultures, had a significantly higher risk of in-hospital mortality. Our multivariate logistic regression analysis showed a higher risk of mortality in patients with pre-existing conditions like hypotension, heart disease, and liver disease. Multivariate logistic regression analysis also showed that presence of Vibrio spp in wound cultures, and presence of Streptococcus Group A in blood cultures were associated with a high risk of mortality while debridement > = 3 was associated with improved survival.ConclusionsMortality in patients with necrotizing fasciitis was significantly associated with the presence of Vibrio in wound cultures and Streptococcus group A in blood cultures.

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Section: Discussionmentioning

confidence: 60%

The microbiological profile and presence of bloodstream infection influence mortality rates in necrotizing fasciitis

Chen

Hong

et al. 2011

Crit Care

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“…Patients with iGAS diseases typically have either low titers, or lack antibodies to the causative GAS serotype suggesting that sufficient levels of circulating antibodies may protect against iGAS diseases [45,46]. Intravenous immunoglobulin (IVIG) contains both opsonic and neutralizing antibodies to several GAS virulence factors [47][48][49][50][51][52]. There has been some clinical success using IVIG to treat iGAS diseases, especially streptococcal toxic shock syndrome [51,53,54]; however, definitive results from robust clinical trials are lacking [55,56].…”

Section: Plos Onementioning

confidence: 99%

Immunotherapy targeting the Streptococcus pyogenes M protein or streptolysin O to treat or prevent influenza A superinfection

et al. 2020

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Viral infections complicated by a bacterial infection are typically referred to as coinfections or superinfections. Streptococcus pyogenes, the group A streptococcus (GAS), is not the most common bacteria associated with influenza A virus (IAV) superinfections but did cause significant mortality during the 2009 influenza pandemic even though all isolates are susceptible to penicillin. One approach to improve the outcome of these infections is to use passive immunization targeting GAS. To test this idea, we assessed the efficacy of passive immunotherapy using antisera against either the streptococcal M protein or streptolysin O (SLO) in a murine model of IAV-GAS superinfection. Prophylactic treatment of mice with antiserum to either SLO or the M protein decreased morbidity compared to mice treated with non-immune sera; however, neither significantly decreased mortality. Therapeutic use of antisera to SLO decreased morbidity compared to mice treated with non-immune sera but neither antisera significantly reduced mortality. Overall, the results suggest that further development of antibodies targeting the M protein or SLO may be a useful adjunct in the treatment of invasive GAS diseases, including IAV-GAS superinfections, which may be particularly important during influenza pandemics.

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“…Though it has been emphasized that severe or invasive disease can develop in anyone, GAS infections, like other bacterial diseases in general, progress in patients with underlying chinks in their defenses. Intact humoral immunity plays a very important role in preventing and combating GAS infections (17). Extremes of age (less than 2 or greater than 65), concurrent acute viral infection, preexisting skin/soft tissue lesions, diabetes mellitus, heart disease, chronic obstructive pulmonary disease, underlying malignancy, and immune suppression from HIV infection or corticosteroids are all associated with increased risk of infection and progression to invasive disease (5,6,8,9,11,16,18).…”

Section: Who Is At Higher Risk For Invasive/severe Infection?mentioning

confidence: 99%

The Shock of Strep: Rapid Deaths Due to Group a Streptococcus

Thompson

Sterkel²,

McBride

et al. 2018

Academic Forensic Pathology

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Streptococcus pyogenes, also known as group A beta-hemolytic strep, is a Gram positive coccus responsible for several million infections every year. The types of infections vary widely from pharyngitis to myositis, but all can advance to severe life threatening invasive disease. Of those infected, approximately 1100 to 1600 people die each year due to invasive disease. Why certain individuals contract severe infections is not known, but many strains of Streptococcus pyogenes are known to produce toxins and superantigens. Invasive Streptococcus pyogenes infections have been shown to cause significant morbidity and rapid mortality. In many cases, patients expire before full antemortem testing can be performed, causing physicians and families to look to forensic pathologists for answers. Understanding the pathogenesis of invasive group A strep infections, relevant gross and microscopic findings, and proper culturing techniques is critical for forensic pathologists to diagnosis this condition and assist in the education and protection of the communities they serve.

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Overdiagnosis of Asthma and Its Relationship to Body Mass Index

Cited by 40 publications

References 26 publications

The microbiological profile and presence of bloodstream infection influence mortality rates in necrotizing fasciitis

The microbiological profile and presence of bloodstream infection influence mortality rates in necrotizing fasciitis

Immunotherapy targeting the Streptococcus pyogenes M protein or streptolysin O to treat or prevent influenza A superinfection

The Shock of Strep: Rapid Deaths Due to Group a Streptococcus

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