Invasive group A streptococcal infections requiring admission to intensive care unit (ICU): a nationwide, multicenter, retrospective study (ISTRE study)
Authors' conclusion
The incidence of iGAS infections requiring ICU admission increased by 4 to 5 after the COVID-19 pandemic. After the COVID-19 pandemic, the rate of STSS was higher, with no significant increase in ICU mortality rate.
Study context
- Population
- Patients admitted to 37 French ICUs for invasive group A streptococcal (iGAS) infection (Group A Streptococcus isolated from a normally sterile site)
- Participants
- 222 patients · 37 French ICUs
- Exposure
- After vs Before
- Aftern = 149
- Beforen = 73reference
- Outcome
- Incidence of iGAS infection requiring ICU admission (case rate per 100,000 ICU admissions)
Methodological detailsmulticentre, nationwide
- Multicentre
- Nationwide
Main finding
As reported in the abstract
Case rate of iGAS infections
P < 0.001
Observational data: associations, not effects.
Further findings
STSS
P = 0.015
ICU mortality
P = 0.135
Factors associated with ICU mortality (multivariate analysis)
| OR (CI) | P value | ||
|---|---|---|---|
| Invasive mechanical ventilation | 6.08 (1.71–21.60) | P = 0.005 | |
| STSS | 5.75 (1.71–19.22) | P = 0.005 | |
| AKI | 4.85 (1.05–22.42) | P = 0.043 | |
| Immunosuppression | 4.02 (1.03–15.59) | P = 0.044 | |
| Diabetes | 3.92 (1.42–10.79) | P = 0.008 | |
| 0.050.21520Odds ratio (log scale) |
- ICU mortality — ICU mortality, all iGAS patients
- 19%
Severity, all iGAS patients
- Median SOFA score
- 8 (5-13)
- Invasive mechanical ventilation
- 61%
- Norepinephrine
- 74%
- n = 222
Original publication
Invasive group A streptococcal infections requiring admission to ICU: a nationwide, multicenter, retrospective study (ISTRE study). Crit Care. Published 2 January 2024. doi:10.
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