SynthesisBMJ open2022
Prognostic factors for streptococcal toxic shock syndrome: systematic review and meta-analysis.
Synthesis in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
23 citing papers in PubMed, 30 citations in OpenAlex.
- Review
- Predominance of M1European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Article
- Appropriateness and Abuse of Antipyretics, Anti-Inflammatory Drugs and Antibiotics in Children and Adults.Antibiotics (Basel, Switzerland) · 2026Review
- Efficacy and Safety of Paracetamol and NSAIDs for Fever and Pain Management in Children with Chronic Diseases: A Narrative Review.Children (Basel, Switzerland) · 2026Review
- Paeniclostridium sordelli toxic shock syndrome after a septic abortion - A case report.IDCases · 2026Article
- Group A streptococcal primary peritonitis and toxic shock syndrome.Clinical journal of gastroenterology · 2025Article
- Streptococcal Toxic Shock Syndrome Secondary to Retroperitoneal Necrotizing Fasciitis: A Case Report.Cureus · 2025Article
- Toxic Shock Syndrome: A Rare but Dangerous Adverse Effect of Anabolic Steroid Injection.Clinical case reports · 2025Article
- Early Diagnosis of Streptococcal Toxic Shock Syndrome With Abdominal Computed Tomography: A Case Report.Cureus · 2025Article
- GAS-J, a User-Friendly Browser Application for Genome Assembly, emm-Typing, MLST Typing, and Virulence Factor Gene Detection of Streptococcus pyogenes.Microbiology and immunology · 2025Article
- The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2024.Journal of intensive care · 2025Article
- Invasive group A Streptococcus infection (Streptococcus pyogenes): Current situation in Spain.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2024Article
- Toxic Shock Syndrome: Rare but Deadly.Cureus · 2024Article
- [Necrotizing soft tissue infections].Die Anaesthesiologie · 2024Review
- Characteristics of Streptococcal Toxic Shock Syndrome Caused by Different Beta-hemolytic Streptococci Species: A Single-center Retrospective Study.Open forum infectious diseases · 2024Article
- Assessing the influence of the COVID-19 pandemic on the incidence, clinical presentation, and clindamycin resistance rates ofIJID regions · 2024Article
- Article
- Toxic Shock Syndrome: A Literature Review.Antibiotics (Basel, Switzerland) · 2024Review
- Perinatal group A streptococcal infection in vagina and its impact on pregnancy outcomes.American journal of translational research · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo quantify the prognostic effects of demographic and modifiable factors in streptococcal toxic shock syndrome (STSS).
designSystematic review and meta-analysis. DATA SOURCES: MEDLINE, EMBASE and CINAHL from inception to 19 September 2022, along with citations of included studies. ELIGIBILITY CRITERIA: Pairs of reviewers independently screened potentially eligible studies of patients with Group A DATA EXTRACTION AND SYNTHESIS: We performed random-effects meta-analysis after duplicate data extraction and risk of bias assessments. We rated the certainty of evidence using the Grading of Recommendations, Assessment, Development and Evaluation approach.
resultsOne randomised trial and 40 observational studies were eligible (n=1918 patients). We found a statistically significant association between clindamycin treatment and mortality (n=144; OR 0.14, 95% CI 0.06 to 0.37), but the certainty of evidence was low. Within clindamycin-treated STSS patients, we found a statistically significant association between intravenous Ig treatment and mortality (n=188; OR 0.34, 95% CI 0.15 to 0.75), but the certainty of evidence was also low. The odds of mortality may increase in patients ≥65 years when compared with patients 18-64 years (n=396; OR 2.37, 95% CI 1.47 to 3.84), but the certainty of evidence was low. We are uncertain whether non-steroidal anti-inflammatory drugs increase the odds of mortality (n=50; OR 4.14, 95% CI 1.13 to 15.14; very low certainty). Results failed to show a significant association between any other prognostic factor and outcome combination (very low to low certainty evidence) and no studies quantified the association between a prognostic factor and morbidity post-infection in STSS survivors.
conclusionsTreatment with clindamycin and within clindamycin-treated patients, IVIG, was each significantly associated with mortality, but the certainty of evidence was low. Future research should focus on morbidity post-infection in STSS survivors. PROSPERO REGISTRATION NUMBER: CRD42020166961.
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