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

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

Objectives: We aimed to compare the clinical features in patients with streptococcal toxic shock syndrome (STSS) caused by the three β-hemolytic streptococci (BHS): Streptococcus pyogenes, Streptococcus agalactiae, and Streptococcus dysgalactiae subsp. equisimilis (SDSE). Methods: Overall, 301 adult...

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Main Authors: 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
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:International Journal of Infectious Diseases
Subjects:
Streptococcal toxic shock syndrome
Beta-hemolytic streptococcal species
Streptococcus pyogenes
Streptococcus agalactiae
Streptococcus dysgalactiae subsp. equisimilis
Online Access:http://www.sciencedirect.com/science/article/pii/S1201971225001869
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Summary:Objectives: We aimed to compare the clinical features in patients with streptococcal toxic shock syndrome (STSS) caused by the three β-hemolytic streptococci (BHS): Streptococcus pyogenes, Streptococcus agalactiae, and Streptococcus dysgalactiae subsp. equisimilis (SDSE). Methods: Overall, 301 adult patients with STSS 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 48-59%; however, the CFR significantly increased with age in patients with SDSE (P <0.05). Conclusions: 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.
ISSN:1201-9712

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