Four cases of unexpected severe community-acquired pneumonia aetiology: Group A Streptococcus pyogenes disruption

Talavera, Mónica; Martínez, Almudena; Vicent, Carlos; Frasquet, Juan; Orera, Ángel; Ramírez, Paula

doi:10.1016/j.medin.2023.04.013

Cited by 1 publication

(1 citation statement)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A significant increase in invasive group A streptococcal (GAS) infections has been observed since September 2022 [1,2] in several European countries and the USA. In our geographical area different series have already been published, showing an increase in their incidence [3]. Streptococcal toxic shock syndrome (STSS) is a critical life-threatening condition, including invasive infections principally by group A streptococcus (GAS, S. pyogenes) [4].…”

Section: Introductionmentioning

confidence: 99%

Catastrophic Streptococcus pyogenes Disease: A Personalized Approach Based on Phenotypes and Treatable Traits

Ruiz-Rodríguez,

Chiscano-Camón,

Maldonado

et al. 2024

Antibiotics

View full text Add to dashboard Cite

Streptococcal toxic shock syndrome (STTS) is a critical medical emergency marked by high morbidity and mortality, necessitating swift awareness, targeted treatment, and early source control due to its rapid symptom manifestation. This report focuses on a cohort of 13 patients admitted to Vall d’Hebron University Hospital Intensive Care Unit, Barcelona, from November 2022 to March 2023, exhibiting invasive Streptococcus pyogenes infections and meeting institutional sepsis code activation criteria. The primary infections were community-acquired pneumonia (61.5%) and skin/soft tissue infection (30.8%). All patients received prompt antibiotic treatment, with clinical source control through thoracic drainage (30.8%) or surgical means (23.1%). Organ support involved invasive mechanical ventilation, vasopressors, and continuous renal replacement therapy as per guidelines. Of note, 76.9% of patients experienced septic cardiomyopathy, and 53.8% required extracorporeal membrane oxygenation (ECMO). The study identified three distinct phenotypic profiles—hyperinflammatory, low perfusion, and hypogammaglobulinemic—which could guide personalized therapeutic approaches. STTS, with a mean SOFA score of 17 (5.7) and a 53.8% requiring ECMO, underscores the need for precision medicine-based rescue therapies and sepsis phenotype identification. Integrating these strategies with prompt antibiotics and efficient source control offers a potential avenue to mitigate organ failure, enhancing patient survival and recovery in the face of this severe clinical condition.

show abstract