RT journal article
T1 Clindamycin but not Intravenous Immunoglobulins reduces mortality in a retrospective cohort of critically ill patients with bacteremic Group A Streptococcal infections
A1 Fernández-Galilea, Adela
A1 Estella García, Ángel
A1 García-Garmendia, José Luis
A1 Loza, Ana
A1 Palacios-García, Inmaculada
A1 Sierra-Camerino, Rafael
A1 Seller, Gemma
A1 Rodríguez-Delgado, Marina
A1 Rodriguez Higueras, Isabel
A1 Garnacho-Montero, José
A2 Medicina
K1 Clindamycin
K1 Intravenous Immunoglobulins
K1 Bacteriemia
K1 Critically ill patients
K1 Group A Streptococcal infections
AB Objectives. Mortality of patients requiring Intensive Care Unit (ICU) admission for an invasive group A streptococcal (GAS) infection continues being high. In critically ill patients with bacteremic GAS infection we aimed at determining risk factors for mortality.Patients and methods. Retrospective multicentre study carried out in nine ICU in Southern Spain. All adult patients admitted to the participant ICUs from January 2014 to June 2019 with one positive blood culture for S. pyogenes were included in this study. Patient characteristics, infection-related variables, therapeutic interventions, failure of organs, and outcomes were registered. Risk factors independently associated with ICU and in-hospital mortalities were determined by multivariate regression analyses.Results. Fifty-seven patients were included: median age was 63 (45-73) years, median SOFA score at admission was 11 (7-13). The most frequent source was skin and soft tissue infection (n=32) followed by unknown origin of bacteremia (n=12). In the multivariate analysis, age (OR 1.079; 95% CI 1.016-1.145), SOFA score (OR 2.129; 95% CI 1.339-3.383) were the risk factors for ICU mortality and the use of clindamycin was identified as a protective factor (OR 0.049; 95% CI 0.0030.737). Age and SOFA were the independent factors associated with hospital mortality however the use of clindamycin showed a strong trend but without reaching statistical significance (OR 0.085; 95% CI 0.007-1.095).Conclusion. In this cohort of critically ill patients the use of intravenous immunoglobulin was not identified as a protective factor for ICU or hospital mortality treatment with clindamycin significantly reduced mortality after controlling for confounders.
PB SOCIEDAD ESPANOLA QUIMIOTERAPIA
SN 1988-9518
YR 2022
FD 2022-10
LK http://hdl.handle.net/10498/28606
UL http://hdl.handle.net/10498/28606
LA eng
DS Repositorio Institucional de la Universidad de Cádiz
RD 13-nov-2026