Clinical Aspects and Disease Severity of Streptococcus dysgalactiae Subspecies equisimilis Bacteremia, Finland1

Abstract

We conducted a prospective study of 159 cases of Streptococcus dysgalactiae subspecies equisimilis (SDSE) bacteremia in 157 patients at 2 hospitals in Finland during November 2015–November 2019. Cellulitis was associated with nonsevere disease (p = 0.008); necrotizing fasciitis was associated with severe disease (p = 0.004). Fifty percent of patients had >1 clinical characteristic associated with risk for death. The case-fatality rate was 6%, and 7% of patients were treated in an intensive care unit. Blood leukocyte counts on days 2 (p = 0.032) and 3 (p = 0.020) and C-reactive protein levels on days 3 (p = 0.030) and 4 (p = 0.009) after admission were predictors of severe disease. The Pitt bacteremia score was an accurate predictor of death. Using the Pitt bacteremia score, leukocyte counts, and CRP responses during initial treatment can improve treatment strategies and survival for patients with SDSE.

Keywords: Finland; Pitt bacteremia score; SDSE; Streptococcus dysgalactiae; Streptococcus dysgalactiae subspecies equisimilis; bacteremia; bacteria; disease severity; group C Streptococcus; group G Streptococcus; intensive care unit; streptococci.

Figure

Association between 30-day mortality and Pitt bacteremia scores in study of clinical aspects and disease severity of Streptococcus dysgalactiae subspecies equisimilis bacteremia, Finland. Pitt bacteremia score was a significant predictor of death for infected patients with bacteremia.