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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Elsevier
2025-09-01
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| Series: | International Journal of Infectious Diseases |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971225001869 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Yuuki Tsuchihashi |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-7b84d0f67aa54b6eaa848c64c9063039 |
| institution | Matheson Library |
| issn | 1201-9712 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj-art-7b84d0f67aa54b6eaa848c64c90630392025-08-04T04:23:54ZengElsevierInternational Journal of Infectious Diseases1201-97122025-09-01158107962Comparative analysis of streptococcal toxic shock syndrome caused by three β-hemolytic streptococcal species in JapanYuuki Tsuchihashi0Kosuke Tamura1Kaoru Matsumoto2Shingo Mitsushima3Yoshihiro Fujiya4Koji Kuronuma5Yoshinari Tanabe6Kei Kasahara7Takaya Maruyama8Kenji Gotoh9Masashi Nakamatsu10Kengo Oshima11Shuichi Abe12Junichiro Nishi13Yu Arakawa14Tadayoshi Ikebe15Tomimasa Sunagawa16Yukihiro Akeda17Kazunori Oishi18Center for Field Epidemic Intelligence, Research and Professional Development, National Institute of Infectious Diseases, Tokyo, JapanToyama Institute of Health, Toyama, JapanField Epidemiology Training Program, National Institute of Infectious Diseases, Tokyo, Japan; Health and Welfare Department, Toyama Prefectural Office, JapanCenter for Field Epidemic Intelligence, Research and Professional Development, National Institute of Infectious Diseases, Tokyo, JapanField Epidemiology Training Program, National Institute of Infectious Diseases, Tokyo, Japan; Hokkaido Institute of Public Health, Hokkaido, JapanSapporo Medical University School of Medicine, Hokkaido, JapanNiigata Prefectural Shibata Hospital, Niigata, JapanNara Medical University, Nara, JapanMie Prefectural Ichishi Hospital, Mie, JapanKurume University School of Medicine, Fukuoka, JapanGraduate School of Medicine, University of the Ryukyus, Okinawa, JapanTohoku University Graduate School of Medicine, Miyagi, JapanYamagata Prefectural Central Hospital, Yamagata, JapanKagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, JapanKochi Medical School, Kochi University, Kochi, JapanDepartment of Bacteriology I, National Institute of Infectious Diseases, Tokyo, JapanCenter for Field Epidemic Intelligence, Research and Professional Development, National Institute of Infectious Diseases, Tokyo, JapanDepartment of Bacteriology I, National Institute of Infectious Diseases, Tokyo, JapanToyama Institute of Health, Toyama, Japan; Correspondences author: (K. Oishi)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.http://www.sciencedirect.com/science/article/pii/S1201971225001869Streptococcal toxic shock syndromeBeta-hemolytic streptococcal speciesStreptococcus pyogenesStreptococcus agalactiaeStreptococcus dysgalactiae subsp. equisimilis |
| spellingShingle | 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 Comparative analysis of streptococcal toxic shock syndrome caused by three β-hemolytic streptococcal species in Japan International Journal of Infectious Diseases Streptococcal toxic shock syndrome Beta-hemolytic streptococcal species Streptococcus pyogenes Streptococcus agalactiae Streptococcus dysgalactiae subsp. equisimilis |
| title | Comparative analysis of streptococcal toxic shock syndrome caused by three β-hemolytic streptococcal species in Japan |
| title_full | Comparative analysis of streptococcal toxic shock syndrome caused by three β-hemolytic streptococcal species in Japan |
| title_fullStr | Comparative analysis of streptococcal toxic shock syndrome caused by three β-hemolytic streptococcal species in Japan |
| title_full_unstemmed | Comparative analysis of streptococcal toxic shock syndrome caused by three β-hemolytic streptococcal species in Japan |
| title_short | Comparative analysis of streptococcal toxic shock syndrome caused by three β-hemolytic streptococcal species in Japan |
| title_sort | comparative analysis of streptococcal toxic shock syndrome caused by three β hemolytic streptococcal species in japan |
| topic | Streptococcal toxic shock syndrome Beta-hemolytic streptococcal species Streptococcus pyogenes Streptococcus agalactiae Streptococcus dysgalactiae subsp. equisimilis |
| url | http://www.sciencedirect.com/science/article/pii/S1201971225001869 |
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