Severe group <scp>A</scp> streptococcal infections in a paediatric intensive care unit

Lithgow, Anna; Duke, Trevor; Steer, Andrew C.; Smeesters, Pierre

doi:10.1111/jpc.12601

Cited by 23 publications

(20 citation statements)

References 29 publications

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“…All the patients who had ECMO also received clindamycin, IVIG and steroids in addition to standard antibiotics. There are limited data on the use of ECMO in TSS with one report of an adult with TSS-induced heart failure and a paediatric series of severe group A streptococcal infections from our institution 18 19. All these reported cases survived.…”

Section: Discussionmentioning

confidence: 99%

Toxic shock syndrome in Australian children

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Toxic shock syndrome in Australian children

et al. 2016

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“…14,28,35 The fatality rate associated with STSS and necrotizing fasciitis was 36% (4/11) and 38% (5/13), respectively. This underscores the highly-specific fatality rate caused by these two conditions, similar to what has been observed by Johansson, who described a 67% STSS fatality rate, compared to 4.9% among those who did not have STSS.…”

Section: Discussionmentioning

confidence: 99%

“…4,6,11,13,35 Also, in this study the time elapsed between the onset of symptoms and the introduction of treatment with adequate antibiotics was not assessed.…”

Section: Discussionmentioning

confidence: 99%

Multicenter study on invasive Streptococcus pyogenes infections in children in Argentina

Cancellara

Melonari

Firpo³

et al. 2016

Arch Argent Pediat

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“…Although studies on critically ill patients with iGAS in the ICU are scarce, studies on all patients admitted to a hospital with iGAS are more common. Mortality in all patients with GAS infection has previously been reported to be 8-23% in the rst 7 days (7,29). Two studies have reported mortality rates of 38-40% in patients with iGAS admitted to the ICU (30,31).…”

Section: Discussionmentioning

confidence: 99%

Morbidity and mortality in critically ill patients with invasive Group A streptococcus infection: an observational study

Björck

Påhlman

Bodelsson

et al. 2020

Preprint

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Background Group A streptococci (GAS) are known to cause serious invasive infections but little is known about outcomes when patients with these infections are admitted to intensive care. We wanted to describe critically ill patients with severe sepsis or septic shock due to invasive GAS (iGAS) and compare them with other patients with severe sepsis or septic shock. Methods Adult patients admitted to a general intensive care unit (ICU) in Sweden (2007-2019) were screened for severe sepsis or septic shock according to Sepsis 2 definition. Individuals with iGAS infection were identified. The outcome variables were mortality, days alive and free of vasopressors and invasive mechanical ventilation, maximum acute kidney injury score for creatinine, use of continuous renal replacement therapy and maximum sequential organ failure assessment score during the ICU stay. Age, simplified acute physiology score (SAPS 3) and iGAS were used as independent, explanatory variables in regression analysis. Cox regression was used for survival analyses. Results iGAS was identified in 53 of 1021 (5.2%) patients. Patients with iGAS presented lower median SAPS 3 score (62 [56–72]) vs 71 [61–81]), p < 0.001), had a higher frequency of cardiovascular cause of admission to the ICU (38 [72%] vs 145 [15%], p < 0.001) and had a higher median creatinine score (173 [100–311] vs 133 [86–208] µmol/L, p < 0.019). Of the GAS isolates, 50% were serotyped emm 1/T1 and this group showed signs of more pronounced circulatory and renal failure than patients with non- emm 1/T1, ( p = 0.036 and p = 0.007, respectively). After correction for severity of illness (SAPS 3) and age, iGAS infection was associated with lower mortality risk; 95% confidence interval (CI) of hazard ratio (HR) 0.204–0.746, p < 0.001. Morbidity analyses demonstrated that iGAS patients were more likely to develop renal failure. Conclusion Critically ill patients with iGAS infection had a lower mortality risk but a higher degree of renal failure compared to similarly ill sepsis patients. emm 1/T1 was found to be the most dominant serotype and patients with emm1 /T1 demonstrated more circulatory and renal failure than patients with other serotypes of iGAS.

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Severe group A streptococcal infections in a paediatric intensive care unit

Cited by 23 publications

References 29 publications

Toxic shock syndrome in Australian children

Toxic shock syndrome in Australian children

Multicenter study on invasive Streptococcus pyogenes infections in children in Argentina

Morbidity and mortality in critically ill patients with invasive Group A streptococcus infection: an observational study

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