日本三种β溶血性链球菌致链球菌中毒性休克综合征的比较分析。

IF 4.8 2区医学 Q1 INFECTIOUS DISEASES

International Journal of Infectious Diseases Pub Date : 2025-06-18 DOI:10.1016/j.ijid.2025.107962

Yuuki Tsuchihashi, Kosuke Tamura, Kaoru Matsumoto, Shingo Mitsushima, Yoshihiro Fujiya, Koji Kuronuma, Yoshinari Tanabe, Kei Kasahara, Takaya Maruyama, Kenji Gotoh, Masashi Nakamatsu, Kengo Oshima, Shuichi Abe, Junichiro Nishi, Yu Arakawa, Tadayoshi Ikebe, Tomimasa Sunagawa, Yukihiro Akeda, Kazunori Oishi

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引用次数: 0

摘要

目的：比较化脓性链球菌、无乳链球菌和欠乳链球菌三种乙型溶血性链球菌（BHS）引起的链球菌中毒性休克综合征（STSS）的临床特点。equisimilis (SDSE)。方法：2016年至2021年，在日本招募了301例合并化脓性链球菌（32.9%）、无乳链球菌（17.6%）和SDSE（49.5%）的成人STSS患者。对数据进行分析，以确定三种BHS患者的临床特征差异。对分离的细菌进行emm或荚膜分型。结果：在新冠肺炎大流行期间，化脓性链球菌感染的STSS发病率下降，而无乳链球菌感染和SDSE感染的STSS发病率没有下降。SDSE患者年龄最大(中位年龄81岁；四分位间距70 ~ 88岁)，其次是无乳链球菌(76岁；67-85岁)和化脓性葡萄球菌(66岁；58 - 78年)。三种BHS引起的STSS病死率（CFRs）无显著差异，在48% ~ 59%之间；然而，SDSE患者的CFR随年龄的增长而显著增加(结论：三种BHS患者的STSS特征不同。临床医生应该意识到STSS患者的不良预后，并在早期阶段提供适当的治疗。

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Comparative analysis of streptococcal toxic shock syndrome caused by three β-hemolytic streptococcal species in Japan.

Objective: We aimed to compare the clinical features in patients with streptococcal toxic shock syndrome (STSS) caused by the three beta-hemolytic streptococci (BHS): Streptococcus pyogenes, Streptococcus agalactiae and Streptococcus dysgalactiae subsp. equisimilis (SDSE).

Methods: Three hundred one adult STSS patients with S. pyogenes (32.9%), S. agalactiae (17.6%), and SDSE (49.5%) in Japan were enrolled between 2016 and 2021. Data were analyzed to identify differences in clinical characteristics among the three BHS. Bacterial isolates were examined for emm or capsular typing.

Results: The incidence of STSS with S. pyogenes declined during the COVID-19 pandemic, but STSS with S. agalactiae and SDSE did not. Patients with SDSE were the oldest (median age, 81 years; interquartile range, 70-88 years) followed by those with S. agalactiae (76 years; 67-85 years) and S. pyogenes (66 years; 58-78 years). The case fatality rates (CFRs) of STSS caused by the three BHS were not significantly different, ranging from 48 to 59%; however, the CFR significantly increased with age in patients with SDSE (p<0.05).

Conclusion: The characteristics of STSS differed among the three BHS. Clinicians should be aware of poor outcomes in patients with STSS, and provide appropriate treatment at an early stage.

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来源期刊

International Journal of Infectious Diseases 医学-传染病学

CiteScore

18.90

自引率

2.40%

发文量

1020

审稿时长

30 days

期刊介绍： International Journal of Infectious Diseases (IJID) Publisher: International Society for Infectious Diseases Publication Frequency: Monthly Type: Peer-reviewed, Open Access Scope: Publishes original clinical and laboratory-based research. Reports clinical trials, reviews, and some case reports. Focuses on epidemiology, clinical diagnosis, treatment, and control of infectious diseases. Emphasizes diseases common in under-resourced countries.