Effect of underlying immune compromise on the manifestations and outcomes of group A streptococcal bacteremia
Recommended Citation
Linder KA, Alkhouli L, Ramesh M, Alangaden GA, Kauffman CA, and Miceli MH. Effect of underlying immune compromise on the manifestations and outcomes of group A streptococcal bacteremia J Infect 2017; 74(5):450-455.
Document Type
Article
Publication Date
5-1-2017
Publication Title
J Infect
Keywords
Adolescent, Adult, Aged, Aged, 80 and over, Bacteremia, Child, Child, Preschool, Fasciitis, Necrotizing, Female, Humans, Immunocompromised Host, Infant, Infant, Newborn, Male, Middle Aged, Retrospective Studies, Risk Factors, Shock, Septic, Soft Tissue Infections, Streptococcal Infections, Streptococcus pyogenes, Young Adult
Abstract
BACKGROUND: Group A streptococcal bloodstream infection is the most common presentation of invasive group A streptococcal disease. We sought to determine the impact of immunosuppression on severity of disease and clinical outcomes.
METHODS: This retrospective review of 148 patients with at least one positive blood culture for Streptococcus pyogenes from 1/2003 to 3/2013 compared immunocompromised patients with those with no immunocompromise in regards to development of severe complications and mortality.
RESULTS: Twenty-five patients (17%) were immunocompromised; 123 were not. Skin and soft tissue infection occurred in 60% of immunocompromised vs. 38% of non-immunocompromised patients, p = .04. Necrotizing fasciitis and septic shock were significantly more common in immunocompromised patients, p < .0001 and .028, respectively. Mortality at 30 days was 32% in immunocompromised patients vs. 16% in non-immunocompromised patients, p = .05.
CONCLUSION: Patients who are immunocompromised are more likely to develop necrotizing fasciitis and septic shock as complications of group A streptococcal bacteremia and have a higher mortality rate than patients who are not immunocompromised.
Medical Subject Headings
Adolescent; Adult; Aged; Aged, 80 and over; Bacteremia; Child; Child, Preschool; Fasciitis, Necrotizing; Female; Humans; Immunocompromised Host; Infant; Infant, Newborn; Male; Middle Aged; Retrospective Studies; Risk Factors; Shock, Septic; Soft Tissue Infections; Streptococcal Infections; Streptococcus pyogenes; Young Adult
PubMed ID
28237623
Volume
74
Issue
5
First Page
450
Last Page
455
