Predictors of mortality in beta-hemolytic streptococcal bacteremia: a population-based study

: Rantala S, Vuopio-Varkila J, Vuento R, Huhtala H, Syrjänen J

: 2009

: Journal of Infection

: The Journal of infection

: J Infect

: 58

: 4

: 266

: 72

: 7

: 0163-4453

: 1532-2742

DOI: https://doi.org/10.1016/j.jinf.2009.01.015

Several factors associated with mortality in Lancefield group A beta-hemolytic streptococcal bacteremia have been described in population-based surveillance studies, whereas such reports on group B, C, and G streptococcal are scant.\nIn this population-based study all 314 episodes of beta-hemolytic streptococcal bacteremia in adult patients in the Pirkanmaa area, Finland, during the 10-year period 1995-2004 were retrospectively reviewed.\nThe 30-day case-fatality rate was 13%, being highest in group C (22%); in group A it was 15%, in group B 7%, and in group G 15%. Confusion, unconsciousness and dyspnea as the first sign or symptom were associated with increased case-fatality, while fever seemed to be a protecting factor for death. Alcoholism and ultimately or rapidly fatal underlying disease were significantly associated with increased case-fatality. Among infections of the skin and soft-tissues, necrotizing fasciitis had the highest risk of death (38%), while patients with cellulitis had a case-fatality of 8%. A history of previous cellulitis seemed to protect against death (case-fatality of 3% as compared to 16% among those without such a history (p=0.014)).\nA history of previous cellulitis seemed to be a protecting factor against death. Fever was also associated with a good prognosis.\nOBJECTIVES\nMETHODS\nRESULTS\nCONCLUSION