Article Dans Une Revue Clinical Infectious Diseases Année : 2021

Menstrual toxic shock syndrome: a French nationwide multicenter retrospective study

1 CH Argenteuil - Centre hospitalier Victor Dupouy [Centre hospitalier d'Argenteuil]
2 CH Départemental Vendée
3 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
4 CHM - Centre Hospitalier de Melun
5 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
6 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
7 LP3 - Laboratoire Lasers, Plasmas et Procédés photoniques
8 CH Angoulême - Centre Hospitalier d'Angoulême
9 UBS Lorient - Université de Bretagne Sud - Lorient
10 CHU de Poitiers [La Milétrie] - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
11 CIC 1402 - CIC de Poitiers – Centre d'investigation clinique de Poitiers (CIC 1402)
12 CIC 1415 - Centre d’Investigation Clinique [CHRU Tours]
13 CHU Limoges - Centre Hospitalier Universitaire Dupuytren 1 et 2
14 CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
15 IMRB - Institut Mondor de Recherche Biomédicale
16 CHU Angers - Centre Hospitalier Universitaire d'Angers
17 Service de Réanimation polyvalente [Chartres]
18 HEGP - Hôpital Européen Georges Pompidou [APHP]
19 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
20 CarMeN - Cardiovasculaire, métabolisme, diabétologie et nutrition
21 APHM - Assistance Publique - Hôpitaux de Marseille
22 UR2CA - Unité de Recherche Clinique Côte d’Azur
23 UniCA - Université Côte d'Azur
24 CHU Nice - Centre Hospitalier Universitaire de Nice
25 CHU Tenon [AP-HP]
26 ORLEANS - Réa - Service de Réanimation
27 Service de Réanimation Médicale [CHU Rouen]
28 Hôpital Charles Nicolle [Rouen]
29 Hôpital Henri Mondor
30 Hôpital de la Croix-Rousse [CHU - HCL]
31 CIRI-StaPath - Pathogénie des Staphylocoques – Staphylococcal Pathogenesis [CIRI]
32 CARMAS - Groupe de recherche clinique CARMAS (Cardiovascular and Respiratory Manifestations of Acute lung injury and Sepsis)
M. Fartoukh
  • Fonction : Auteur

Résumé

BACKGROUND: Studies describing the clinical features and short-term prognosis of patients admitted to the intensive care unit (ICU) for menstrual toxic shock syndrome (m-TSS) are lacking. METHODS: This was a multicenter retrospective cohort study of patients with a clinical diagnosis of m-TSS admitted between January 1, 2005 and December 31, 2020 in 43 French pediatric (n=7) or adult (n=36) ICUs. The aim of the study was to describe the clinical features and short-term prognosis, as well as assess the 2011 Centers for Disease and Control (CDC) diagnostic criteria, of critically ill patients with m-TSS. RESULTS: In total, 102 patients with m-TSS (median age: 18 [16-24] years) were admitted to one of the participating ICUs. All blood cultures (n=102) were sterile. Methicillin-sensitive Staphylococcus aureus grew from 92 of 96 vaginal samples. Screening for super-antigenic toxin gene sequences was performed for 76 of the 92 (83%) vaginal samples positive for Staphylococcus aureus and TSST-1 isolated from 66 (87%) strains. At ICU admission, no patient met the 2011 CDC criteria for confirmed m-TSS and only 53 (52%) fulfilled the criteria for probable m-TSS. Eighty-one patients (79%) were treated with anti-toxin antibiotic therapy and eight (8%) received intravenous immunoglobulins. Eighty-six (84%) patients required vasopressors and 21 (21%) tracheal intubation. No patient required limb amputation or died in the ICU. CONCLUSIONS: In this large multicenter series of patients included in ICUs for m-TSS, none died or required limb amputation. The CDC criteria should not be used for the clinical diagnosis of m-TSS at ICU admission.

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inserm-03337964 , version 1 (08-09-2021)

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D. Contou, G. Colin, B. Travert, S. Jochmans, M. Conrad, et al.. Menstrual toxic shock syndrome: a French nationwide multicenter retrospective study. Clinical Infectious Diseases, 2021, 74 (2), pp.246-253. ⟨10.1093/cid/ciab378⟩. ⟨inserm-03337964⟩
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