PMID- 24928291
OWN - NLM
STAT- MEDLINE
DCOM- 20150511
LR  - 20220408
IS  - 1537-6591 (Electronic)
IS  - 1058-4838 (Linking)
VI  - 59
IP  - 6
DP  - 2014 Sep 15
TI  - Clinical efficacy of polyspecific intravenous immunoglobulin therapy in patients 
      with streptococcal toxic shock syndrome: a comparative observational study.
PG  - 851-7
LID - 10.1093/cid/ciu449 [doi]
AB  - BACKGROUND: Streptococcal toxic shock syndrome (STSS) and necrotizing fasciitis 
      are the 2 most severe invasive manifestations caused by group A Streptococcus 
      (GAS). Intravenous immunoglobulin (IVIG) therapy has been suggested as adjunctive 
      treatment with a beneficial effect on mortality. However the clinical evidence is 
      limited. Here we aim to further document the clinical efficacy of administered 
      IVIG therapy in a comparative observational study of well-defined patients with 
      STSS. METHODS: The effect of IVIG was evaluated in patients with STSS 
      prospectively identified in a nationwide Swedish surveillance study conducted 
      between April 2002 and December 2004. Detailed data on symptoms, severity of 
      disease, treatment, and outcome were obtained from 67 patients. Crude and 
      adjusted analyses with logistic regression were performed. RESULTS: Twenty-three 
      patients received IVIG therapy compared with 44 who did not. No significant 
      difference in comorbidities, severity of disease, organ failures, or sex was 
      seen, but the IVIG group was slightly younger and had a higher degree of 
      necrotizing fasciitis (56% vs 14%). The primary endpoint was 28-day survival. 
      Adjusted analysis revealed that factors influencing survival in STSS were 
      Simplified Acute Physiology Score II (odds ratio [OR], 1.1; P = .007), 
      clindamycin (OR, 8.6; P = .007), and IVIG (OR, 5.6; P = .030). CONCLUSIONS: This 
      comparative observational study of prospectively identified STSS patients 
      demonstrates that both IVIG and clindamycin therapy contribute to a significantly 
      improved survival in STSS.
CI  - (c) The Author 2014. Published by Oxford University Press on behalf of the 
      Infectious Diseases Society of America. All rights reserved. For Permissions, 
      please e-mail: journals.permissions@oup.com.
FAU - Linner, Anna
AU  - Linner A
AD  - Department of Medicine Huddinge, Center for Infectious Medicine, Karolinska 
      Institutet, Stockholm.
FAU - Darenberg, Jessica
AU  - Darenberg J
AD  - Public Health Agency of Sweden, Solna.
FAU - Sjolin, Jan
AU  - Sjolin J
AD  - Department of Infectious Diseases, Uppsala University.
FAU - Henriques-Normark, Birgitta
AU  - Henriques-Normark B
AD  - Public Health Agency of Sweden, Solna Department of Microbiology, Tumor and Cell 
      Biology, Karolinska Institutet, Stockholm Karolinska University Hospital, Solna, 
      Sweden.
FAU - Norrby-Teglund, Anna
AU  - Norrby-Teglund A
AD  - Department of Medicine Huddinge, Center for Infectious Medicine, Karolinska 
      Institutet, Stockholm.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140613
PL  - United States
TA  - Clin Infect Dis
JT  - Clinical infectious diseases : an official publication of the Infectious Diseases 
      Society of America
JID - 9203213
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Immunoglobulins, Intravenous)
RN  - 3U02EL437C (Clindamycin)
SB  - IM
CIN - Clin Infect Dis. 2015 Jan 15;60(2):324-5. PMID: 25313251
CIN - Clin Infect Dis. 2015 Jan 15;60(2):324. PMID: 25313253
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Anti-Bacterial Agents/therapeutic use
MH  - Clindamycin/therapeutic use
MH  - Comorbidity
MH  - Female
MH  - Humans
MH  - Immunoglobulins, Intravenous/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Odds Ratio
MH  - Prognosis
MH  - Prospective Studies
MH  - Shock, Septic/diagnosis/mortality/*therapy
MH  - Streptococcal Infections/diagnosis/microbiology/mortality/*therapy
MH  - Streptococcus pyogenes/classification/genetics
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Streptococcus pyogenes
OT  - clindamycin
OT  - necrotizing fasciitis
OT  - polyspecific intravenous immunoglobulin
OT  - streptococcal toxic shock syndrome
EDAT- 2014/06/15 06:00
MHDA- 2015/05/12 06:00
CRDT- 2014/06/15 06:00
PHST- 2014/06/15 06:00 [entrez]
PHST- 2014/06/15 06:00 [pubmed]
PHST- 2015/05/12 06:00 [medline]
AID - ciu449 [pii]
AID - 10.1093/cid/ciu449 [doi]
PST - ppublish
SO  - Clin Infect Dis. 2014 Sep 15;59(6):851-7. doi: 10.1093/cid/ciu449. Epub 2014 Jun 
      13.