{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:08:01Z","timestamp":1792786081281,"version":"4.5.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2024,8,27]],"date-time":"2024-08-27T00:00:00Z","timestamp":1724716800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012319","name":"National Center for Global Health and Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012319","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Intramural Research Fund","award":["22 A1016"],"award-info":[{"award-number":["22 A1016"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Streptococcal toxic shock syndrome (STSS) is a life-threatening condition caused by beta-hemolytic streptococci (BHS). Streptococcus pyogenes is the main causative agent of this disease; other BHS such as Streptococcus agalactiae or Streptococcus dysgalactiae could also cause STSS. However, the clinical characteristics of STSS caused by other types of BHS remain poorly understood. In this study, we evaluated the likelihood of STSS development in various streptococcal species.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective observational study using adult medical records of patients with invasive BHS in a tertiary care institution from 2002 to 2022 and classified them into STSS or non-STSS groups. Multivariable analysis of bacterial species adjusted for age and diabetes mellitus was conducted. S pyogenes cases were propensity-matched (1:4) to non-pyogenes BHS cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 43 STSS and 285 non-STSS cases were identified. S pyogenes, S agalactiae, and S dysgalactiae accounted for 17, 13, and 13 STSS cases, respectively. The crude mortality of STSS was approximately 35% in all groups. A multivariable analysis suggested that STSS was less frequent in S agalactiae and S dysgalactiae cases with odds ratio 0.24 (95% confidence interval [CI], 0.10\u20130.54; P &amp;lt; .001) and 0.23 (95% CI, .10\u2013.55; P &amp;lt; .001), respectively. Propensity score matching showed that S pyogenes caused STSS more frequently than other BHS cases with an odds ratio of 3.28 (95% CI 1.21\u20138.77; P = .010).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study described and compared the clinical characteristics of STSS caused by different BHS. We demonstrated that S pyogenes caused STSS more often than other BHS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofae486","type":"journal-article","created":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T03:44:31Z","timestamp":1724643871000},"source":"Crossref","is-referenced-by-count":7,"title":["Characteristics of Streptococcal Toxic Shock Syndrome Caused by Different Beta-hemolytic Streptococci Species: A Single-center Retrospective Study"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8290-748X","authenticated-orcid":false,"given":"Makoto","family":"Inada","sequence":"first","affiliation":[{"name":"Disease Control and Prevention Center, National Center for Global Health and Medicine , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5471-7363","authenticated-orcid":false,"given":"Noriko","family":"Iwamoto","sequence":"additional","affiliation":[{"name":"Disease Control and Prevention Center, National Center for Global Health and Medicine , Tokyo ,","place":["Japan"]},{"name":"AMR Clinical Reference Center, National Center for Global Health and Medicine , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9323-3924","authenticated-orcid":false,"given":"Hidetoshi","family":"Nomoto","sequence":"additional","affiliation":[{"name":"Disease Control and Prevention Center, National Center for Global Health and Medicine , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5732-846X","authenticated-orcid":false,"given":"Shinya","family":"Tsuzuki","sequence":"additional","affiliation":[{"name":"Disease Control and Prevention Center, National Center for Global Health and Medicine , Tokyo ,","place":["Japan"]},{"name":"AMR Clinical Reference Center, National Center for Global Health and Medicine , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3757-1977","authenticated-orcid":false,"given":"Norihiko","family":"Takemoto","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Research Institute, National Center for Global Health and Medicine , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriko","family":"Fuwa","sequence":"additional","affiliation":[{"name":"Disease Control and Prevention Center, National Center for Global Health and Medicine , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ataru","family":"Moriya","sequence":"additional","affiliation":[{"name":"Laboratory Testing Department, National Center for Global Health and Medicine , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4622-8970","authenticated-orcid":false,"given":"Norio","family":"Ohmagari","sequence":"additional","affiliation":[{"name":"Disease Control and Prevention Center, National Center for Global Health and Medicine , Tokyo ,","place":["Japan"]},{"name":"AMR Clinical Reference Center, National Center for Global Health and Medicine , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,8,27]]},"reference":[{"key":"2024092714543272600_ofae486-B1","doi-asserted-by":"crossref","first-page":"e0211786","DOI":"10.1371\/journal.pone.0211786","article-title":"Age-related differences in clinical characteristics of invasive group G streptococcal infection: comparison with group A and group B streptococcal infections","volume":"14","author":"Fujiya","year":"2019","journal-title":"PLoS One"},{"key":"2024092714543272600_ofae486-B2","doi-asserted-by":"crossref","first-page":"973","DOI":"10.3390\/antibiotics10080973","article-title":"Antimicrobial resistance among beta-hemolytic Streptococcus in Brazil: an overview","volume":"10","author":"Barros","year":"2021","journal-title":"Antibiotics (Basel)"},{"key":"2024092714543272600_ofae486-B3","doi-asserted-by":"crossref","first-page":"797","DOI":"10.3389\/fmicb.2020.00797","article-title":"Emerging threat of antimicrobial resistance in (-hemolytic streptococci","volume":"11","author":"Oppegaard","year":"2020","journal-title":"Front Microbiol"},{"key":"2024092714543272600_ofae486-B4","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.1016\/S1473-3099(21)00672-1","article-title":"Invasive group A streptococcal disease in pregnant women and young children: a systematic review and meta-analysis","volume":"22","author":"Sherwood","year":"2022","journal-title":"Lancet Infect Dis"},{"key":"2024092714543272600_ofae486-B5","article-title":"Increased incidence of scarlet fever and invasive Group A Streptococcus infection - 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