Invasive group A streptocomd infections in Florida

被引:63
作者
Mulla, ZD
Leaverton, PE
Wiersma, ST
机构
[1] Univ S Florida, Dept Epidemiol & Biostat, Tampa, FL USA
[2] Florida Dept Hlth, Bur Epidemiol, Tampa, FL USA
关键词
D O I
10.1097/01.SMJ.0000051060.95210.9A
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Several previous studies of invasive Group A streptococcal (GAS) disease have been hindered by small sample sizes (less than or equal to 100 patients) and limited generalizability. Methods: We conducted a population-based study of invasive GAS disease. The objectives of the study were to describe the clinical features of individuals who were hospitalized for invasive GAS disease and to identify risk factors for hospital mortality. The cases were 257 patients who were hospitalized throughout Florida during a 4-year period and reported to the Florida Department of Health. Logistic regression was used to calculate adjusted odds ratios (OR) for mortality and 95% confidence intervals (CI). Results: The overall mortality was 18% (41 of 228). Admission into an intensive care unit was a strong predictor of mortality (OR, 20.41; 95% CI, 6.41-64.96). Treatment with clindamycin reduced mortality in patients who had necrotizing fasciitis (OR, 0.11; 95% Cl, 0.01-0.89) but not in patients who did not have necrotizing fasciltlis (OR, 1.01; 95% CI, 0.31-3.33). Conclusion: Clindamycin reduces mortality in patients with invasive GAS disease who have necrotizing fasciitis.
引用
收藏
页码:968 / 973
页数:6
相关论文
共 24 条
[1]  
*AM PUBL HLTH ASS, 2000, CONTR COMM DIS MAN, P470
[2]  
Basma H, 1999, INFECT IMMUN, V67, P1871
[3]  
BISNO AL, 1995, MANDELL DOUGLAS BENN, P1786
[4]   DEFINING THE GROUP-A STREPTOCOCCAL TOXIC SHOCK SYNDROME - RATIONALE AND CONSENSUS DEFINITION [J].
BREIMAN, RF ;
DAVIS, JP ;
FACKLAM, RR ;
GRAY, BM ;
HOGE, CW ;
KAPLAN, EL ;
MORTIMER, EA ;
SCHLIEVERT, PM ;
SCHWARTZ, B ;
STEVENS, DL ;
TODD, JK .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1993, 269 (03) :390-391
[5]  
*CDCP, 1999, MMWR-MORBID MORTAL W, V47, pR2
[6]  
*CDCP DIV BACT MYC, 1999, STREPTOCOCCUS
[7]   Invasive group a streptococcal infections in Ontario, Canada [J].
Davies, HD ;
McGeer, A ;
Schwartz, B ;
Green, K ;
Cann, D ;
Simor, AE ;
Low, DE ;
Fletcher, A ;
Kaul, R ;
Scriver, S ;
Willey, B ;
Demers, B ;
Gold, W ;
Lovgren, M ;
Talbot, J ;
Naus, M .
NEW ENGLAND JOURNAL OF MEDICINE, 1996, 335 (08) :547-554
[8]   Group A streptococcal bacteremia - A 10-year prospective study [J].
deQuiros, JCLB ;
Moreno, S ;
Cercenado, E ;
Diaz, D ;
Berenguer, J ;
Miralles, P ;
Catalan, P ;
Bouza, E .
MEDICINE, 1997, 76 (04) :238-248
[9]   Epidemiological and clinical aspects of invasive group A streptococcal infections and the streptococcal toxic shock syndrome [J].
Eriksson, BKG ;
Andersson, J ;
Holm, SE ;
Norgren, M .
CLINICAL INFECTIOUS DISEASES, 1998, 27 (06) :1428-1436
[10]  
*FLOR DEP HLTH BUR, FLOR MORB STAT 1996, P83