Menstrual Toxic Shock Syndrome: A French Nationwide Multicenter Retrospective Study

被引：6

作者：

Contou, Damien ^{[1
]}

Colin, Gwenhael ^{[2
]}

Travert, Brendan ^{[3
]}

Jochmans, Sebastien ^{[4
,5
]}

Conrad, Marie ^{[6
]}

Lascarrou, Jean-Baptiste ^{[7
]}

Painvin, Benoit ^{[8
]}

Ferre, Alexis ^{[9
]}

Schnell, David ^{[10
]}

La Combe, Beatrice ^{[11
]}

Coudroy, Remi ^{[12
,13
]}

Ehrmann, Stephan ^{[14
]}

Rambaud, Jerome ^{[15
]}

Wiedemann, Arnaud ^{[16
]}

Asfar, Pierre ^{[17
]}

Kalfon, Pierre ^{[18
]}

Guerot, Emmanuel ^{[19
]}

Preau, Sebastien ^{[20
]}

Argaud, Laurent ^{[21
]}

Daviet, Florence ^{[22
]}

Dellamonica, Jean ^{[23
]}

Dupont, Audrey ^{[24
]}

Fartoukh, Muriel ^{[25
]}

Kamel, Toufik ^{[26
]}

Beduneau, Gaetan ^{[27
]}

Canoui-Poitrine, Florence ^{[28
]}

Boutin, Emmanuelle ^{[28
]}

Lina, Gerard ^{[29
]}

Dessap, Armand Mekontso ^{[30
]}

Tristan, Anne ^{[29
]}

de Prost, Nicolas ^{[30
]}

机构：

[1] Ctr Hosp Victor Dupouy, Serv Reanimat Polyvalente, 69 Rue Lieutenant Colonel Prudhon, F-95100 Argenteuil, France

[2] Ctr Hosp Dept Vendee, Serv Med Intens Reanimat, Blvd Stephane Moreau, La Roche Sur Yon, France

[3] Ctr Hosp Univ Nantes, Serv Reanimat Pediat, Nantes, France

[4] Grp Hosp Sud Ile de France, Serv Med Intens Reanimat, Melun, France

[5] Hop Melun Senart, Melun, France

[6] Ctr Hosp Univ Nancy, Serv Reanimat, Nancy, France

[7] Ctr Hosp Univ Nantes, Serv Med Intens & Reanimat, Nantes, France

[8] Ctr Hosp Univ Rennes, Serv Malad Infect & Reanimat Med, Rennes, France

[9] Ctr Hosp Andre Mignot Versailles, Serv Reanimat Med Chirurg, Le Chesnay, France

[10] Ctr Hosp Angouleme, Serv Med Reanimat Polyvalente, Angouleme, France

[11] Hop Scorff Grp Hosp Bretagne Sud Lorient, Serv Reanimat Med Chirurg, Lorient, France

[12] Ctr Hosp Univ Poitiers, Serv Med Intens & Reanimat, Poitiers, France

[13] Univ Poitiers, ALIVE Grp, INSERM CIC1402, Poitiers, France

[14] Univ Tours, INSERM U1100, Ctr Etud Pathol Resp, CRICS TriggerSEP,CHRU Tours,CIC 1415,Serv Med Int, Tours, France

[15] Hop Trousseau, AP HP, Serv Reanimat Pediat, Paris, France

[16] CHRU, INSERM U1256 N GERE & Reanimat Pediat Specialisee, Vandoeuvre Les Nancy, France

[17] Ctr Hosp Univ Angers, Dept Med Intens Reanimat, Angers, France

[18] Ctr Hosp Chartres, Serv Reanimat, Le Coudray, France

[19] Hop Europeen Georges Pompidou, AP HP, Serv Med Intens Reanimat, Paris, France

[20] Ctr Hosp Univ Lille, Serv Reanimat, Lille, France

[21] Hop Edouard Herriot, Serv Med Intens Reanimat, Lyon, France

[22] Aix Marseille Univ, Hop Nord, Assistance Publ Hop Marseille, Serv Med Intens Reanimat, Chemin Bourrely, Marseille, France

[23] UR2CA Univ Cote Azur, Ctr Hosp Univ Nice, Serv Med Intens Reanimat, Nice, France

[24] Ctr Hosp Univ Nice, Serv Reanimat Pediat, Nice, France

[25] Sorbonne Univ, Ctr Hosp Univ Tenon AP HP, AP HP, Serv Med Intens Reanimat, Paris, France

[26] Ctr Hosp Reg Orleans, Serv Med Intens Reanimat, Hop La Source, Orleans, France

[27] Univ Normandie, Ctr Hosp Univ Rouen, Serv Reanimat Med, UNIROUEN,EA3830, Rouen, France

[28] Hop Henri Mondor, AP HP, Serv Sante Publ, Creteil, France

[29] Hosp Civils Lyon, Ctr Natl Reference Staphylocoques, Inst Agent Infect, Hop Croix Rousse, Lyon, France

[30] Ctr Hosp Univ Henri Mondor, Assistance Publ Hop Paris, Serv Med Intens Reanimat, Grp Rech CARMAS, Creteil, France

来源：

CLINICAL INFECTIOUS DISEASES | 2022年 / 74卷 / 02期

关键词：

menstrual toxic shock syndrome; menstruation; sepsis; Staphylococcus; aureus; ICU; tampon; STAPHYLOCOCCUS-AUREUS; TAMPON USE; GENES; SCORE;

D O I：

10.1093/cid/ciab378

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background Studies describing the clinical features and short-term prognosis of patients admitted to the intensive care unit (ICU) for menstrual toxic shock syndrome (m-TSS) are lacking. Methods This was a multicenter retrospective cohort study of patients with a clinical diagnosis of m-TSS admitted between 1 January 2005 and 31 December 2020 in 43 French pediatric (n = 7) or adult (n = 36) ICUs. The aim of the study was to describe the clinical features and short-term prognosis, as well as to assess the 2011 Centers for Disease and Control (CDC) diagnostic criteria, in critically ill patients with m-TSS. Results In total, 102 patients with m-TSS (median age, 18 years; interquartile range, 16-24 years) were admitted to 1 of the participating ICUs. All blood cultures (n = 102) were sterile. Methicillin-sensitive Staphylococcus aureus grew from 92 of 96 vaginal samples. Screening for superantigenic toxin gene sequences was performed for 76 of the 92 vaginal samples positive for S. aureus (83%), and toxic shock syndrome toxin 1 was isolated from 66 strains (87%). At ICU admission, no patient met the 2011 CDC criteria for confirmed m-TSS, and only 53 (52%) fulfilled the criteria for probable m-TSS. Eighty-one patients (79%) were treated with antitoxin antibiotic therapy, and 8 (8%) received intravenous immunoglobulins. Eighty-six (84%) patients required vasopressors, and 21 (21%) tracheal intubation. No patient required limb amputation or died in the ICU. Conclusions In this large multicenter series of patients included in ICUs for m-TSS, none died or required limb amputation. The CDC criteria should not be used for the clinical diagnosis of m-TSS at ICU admission. None of the patients with menstrual toxic shock syndrome required limb amputation or died despite a high rate of vasopressor support and invasive mechanical ventilation. Centers for Disease Control and Prevention criteria should not be used for clinical diagnosis at intensive care unit admission.

引用

页码：246 / 253

页数：8

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