• Something wrong with this record ?

Toxic epidermal necrolysis data from the CELESTE multinational registry. Part I: Epidemiology and general microbiological characteristics

B. Lipový, J. Holoubek, M. Hanslianová, M. Cvanová, L. Klein, I. Grossová, R. Zajíček, P. Bukovčan, J. Koller, M. Baran, P. Lengyel, L. Eimer, M. Jandová, M. Košťál, P. Brychta, CELESTE Study Group,

. 2018 ; 44 (6) : 1551-1560. [pub] 20180607

Language English Country Netherlands

Document type Journal Article

Persistent link   https://www.medvik.cz/link/bmc19028386

INTRODUCTION: Toxic epidermal necrolysis (TEN) is a rare, life-threatening autoimmune disease predominantly manifested in the skin and mucous membranes. Today, infectious complications have the dominant share in mortality of TEN patients. Due to the nature of the therapy and administration of immunosuppressive medications, a wide range of potentially pathogenic microorganisms, which cause infectious complications in different compartments in these patients, is not surprising. MATERIAL AND METHODOLOGY: This is a multicentric study, which included all patients with TEN hospitalized between 2000-2015 in specialized centres in the Czech Republic and Slovakia. The total catchment area was over 12.5 million inhabitants. The actual implementation of the project was carried out using data obtained from the registry CELESTE (Central European LyEll Syndrome: Therapeutic Evaluation), when specific parameters relating to epidemiological indicators and infectious complications in patients with TEN were evaluated in the form of a retrospective analysis. RESULTS: In total, 39 patients with TEN were included in the study (12 patients died, mortality was 31%), who were hospitalized in the monitored period. The median age of patients in the group was 63 years (the range was 4-83 years, the mean was 51 years), the median of the exfoliated area was 70% TBSA (total body surface area) (range 30-100%, mean 67%). SCORTEN was calculated for 38 patients on the day of admission. Its median in all patients was 3 (range 1-6; mean 3). Any kind of infectious complication in the study group was recorded in 33 patients in total (85%). In total, 30 patients (77%) were infected with gram-positive cocci, 27 patients (69%) with gram-negative rods, and yeast cells or fibrous sponge were cultivated in 12 patients (31%). A total of 32 patients (82%) were found to have infectious complications in the exfoliated area, 15 patients (39%) had lower respiratory tract infections, 18 patients (46%) urinary tract infections and 15 patients (39%) an infection in the bloodstream. The most common potentially pathogenic microorganism isolated in our study group was coagulase neg. Staphylococcus, which caused infectious complications in 24 patients. Enterococcus faecalis/faecium (19 patients), Pseudomonas aeruginosa (17 patients), Staphylococcus aureus (11 patients) and Escherichia coli (11 patients) were other most frequently isolated micro-organisms. CONCLUSION: The published data were obtained from the unique registry of TEN patients in Central Europe. In the first part, we have succeeded in defining the basic epidemiological indicators in the group of patients anonymously included in this registry. The study clearly confirms that infectious complications currently play an essential role in TEN patients, often limiting the chances of survival. The study also shows a high prevalence of these complications in the period after 15days from the start of hospitalization, when most patients already have completely regenerated skin cover.

References provided by Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc19028386
003      
CZ-PrNML
005      
20250603083745.0
007      
ta
008      
190813s2018 ne f 000 0|eng||
009      
AR
024    7_
$a 10.1016/j.burns.2018.01.019 $2 doi
035    __
$a (PubMed)29886114
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a ne
100    1_
$a Lipový, B $u Department of Burns and Reconstructive Surgery, Teaching Hospital Brno, Czech Republic; Faculty of Medicine, Masaryk University Brno, Czech Republic. Electronic address: b.lipovy@seznam.cz.
245    10
$a Toxic epidermal necrolysis data from the CELESTE multinational registry. Part I: Epidemiology and general microbiological characteristics / $c B. Lipový, J. Holoubek, M. Hanslianová, M. Cvanová, L. Klein, I. Grossová, R. Zajíček, P. Bukovčan, J. Koller, M. Baran, P. Lengyel, L. Eimer, M. Jandová, M. Košťál, P. Brychta, CELESTE Study Group,
520    9_
$a INTRODUCTION: Toxic epidermal necrolysis (TEN) is a rare, life-threatening autoimmune disease predominantly manifested in the skin and mucous membranes. Today, infectious complications have the dominant share in mortality of TEN patients. Due to the nature of the therapy and administration of immunosuppressive medications, a wide range of potentially pathogenic microorganisms, which cause infectious complications in different compartments in these patients, is not surprising. MATERIAL AND METHODOLOGY: This is a multicentric study, which included all patients with TEN hospitalized between 2000-2015 in specialized centres in the Czech Republic and Slovakia. The total catchment area was over 12.5 million inhabitants. The actual implementation of the project was carried out using data obtained from the registry CELESTE (Central European LyEll Syndrome: Therapeutic Evaluation), when specific parameters relating to epidemiological indicators and infectious complications in patients with TEN were evaluated in the form of a retrospective analysis. RESULTS: In total, 39 patients with TEN were included in the study (12 patients died, mortality was 31%), who were hospitalized in the monitored period. The median age of patients in the group was 63 years (the range was 4-83 years, the mean was 51 years), the median of the exfoliated area was 70% TBSA (total body surface area) (range 30-100%, mean 67%). SCORTEN was calculated for 38 patients on the day of admission. Its median in all patients was 3 (range 1-6; mean 3). Any kind of infectious complication in the study group was recorded in 33 patients in total (85%). In total, 30 patients (77%) were infected with gram-positive cocci, 27 patients (69%) with gram-negative rods, and yeast cells or fibrous sponge were cultivated in 12 patients (31%). A total of 32 patients (82%) were found to have infectious complications in the exfoliated area, 15 patients (39%) had lower respiratory tract infections, 18 patients (46%) urinary tract infections and 15 patients (39%) an infection in the bloodstream. The most common potentially pathogenic microorganism isolated in our study group was coagulase neg. Staphylococcus, which caused infectious complications in 24 patients. Enterococcus faecalis/faecium (19 patients), Pseudomonas aeruginosa (17 patients), Staphylococcus aureus (11 patients) and Escherichia coli (11 patients) were other most frequently isolated micro-organisms. CONCLUSION: The published data were obtained from the unique registry of TEN patients in Central Europe. In the first part, we have succeeded in defining the basic epidemiological indicators in the group of patients anonymously included in this registry. The study clearly confirms that infectious complications currently play an essential role in TEN patients, often limiting the chances of survival. The study also shows a high prevalence of these complications in the period after 15days from the start of hospitalization, when most patients already have completely regenerated skin cover.
650    _2
$a mladiství $7 D000293
650    _2
$a dospělí $7 D000328
650    _2
$a senioři $7 D000368
650    _2
$a senioři nad 80 let $7 D000369
650    _2
$a aspergilóza $x epidemiologie $x mortalita $7 D001228
650    _2
$a bakteriemie $x epidemiologie $x mikrobiologie $x mortalita $7 D016470
650    _2
$a bakteriální infekce $x epidemiologie $x mikrobiologie $x mortalita $7 D001424
650    _2
$a povrch těla $7 D001830
650    _2
$a kandidóza $x epidemiologie $x mortalita $7 D002177
650    _2
$a katétrové infekce $x epidemiologie $x mikrobiologie $x mortalita $7 D055499
650    _2
$a dítě $7 D002648
650    _2
$a předškolní dítě $7 D002675
650    _2
$a Enterococcus faecalis $7 D013293
650    _2
$a Enterococcus faecium $7 D016984
650    _2
$a infekce vyvolané Escherichia coli $x epidemiologie $x mortalita $7 D004927
650    _2
$a ženské pohlaví $7 D005260
650    _2
$a lidé $7 D006801
650    _2
$a mužské pohlaví $7 D008297
650    _2
$a lidé středního věku $7 D008875
650    _2
$a mykózy $x epidemiologie $x mikrobiologie $x mortalita $7 D009181
650    _2
$a pneumonie $x epidemiologie $x mikrobiologie $x mortalita $7 D011014
650    _2
$a prevalence $7 D015995
650    _2
$a proporcionální rizikové modely $7 D016016
650    _2
$a pseudomonádové infekce $x epidemiologie $x mikrobiologie $x mortalita $7 D011552
650    _2
$a Pseudomonas aeruginosa $7 D011550
650    12
$a registrace $7 D012042
650    _2
$a stafylokokové infekce $x epidemiologie $x mikrobiologie $x mortalita $7 D013203
650    _2
$a Staphylococcus aureus $7 D013211
650    _2
$a Stevensův-Johnsonův syndrom $x epidemiologie $x mikrobiologie $x mortalita $7 D013262
650    _2
$a infekce močového ústrojí $x epidemiologie $x mikrobiologie $x mortalita $7 D014552
650    _2
$a mladý dospělý $7 D055815
651    _2
$a Česká republika $x epidemiologie $7 D018153
651    _2
$a Slovenská republika $x epidemiologie $7 D018154
655    _2
$a časopisecké články $7 D016428
700    1_
$a Holoubek, J $u Department of Burns and Reconstructive Surgery, Teaching Hospital Brno, Czech Republic.
700    1_
$a Hanslianová, M $u Department of Clinical Microbiology, Teaching Hospital Brno, Czech Republic.
700    1_
$a Cvanová, M $u Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
700    1_
$a Klein, L $u Division of Plastic Surgery and Burns Treatment, Department of Surgery, Charles University, Faculty of Medicine and Teaching Hospital, Hradec Králové, Czech Republic; Department of Military Surgery, Faculty of Military Health Sciences, University of Defence, Hradec Králové, Czech Republic.
700    1_
$a Grossová, Ivana $7 xx0239473 $u Prague Burn Center, Charles University, 3rd Faculty of Medicine and Teaching Hospital Královské Vinohrady, Prague, Czech Republic.
700    1_
$a Zajíček, Robert $u Prague Burn Center, Charles University, 3rd Faculty of Medicine and Teaching Hospital Královské Vinohrady, Prague, Czech Republic. $7 xx0098569
700    1_
$a Bukovčan, P $u Department of Burns and Reconstructive Surgery, Faculty of Medicine, Comenius University in Bratislava, Slovakia.
700    1_
$a Koller, J $u Department of Burns and Reconstructive Surgery, Faculty of Medicine, Comenius University in Bratislava, Slovakia.
700    1_
$a Baran, Matúš, $d 1986- $u Department of Burns and Reconstructive Surgery, 1st Private Hospital Košice-Šaca, Slovakia. $7 xx0328720
700    1_
$a Lengyel, Peter $7 xx0241994 $u Department of Burns and Reconstructive Surgery, 1st Private Hospital Košice-Šaca, Slovakia.
700    1_
$a Eimer, L $u Department of Paediatrics, Charles University, Faculty of Medicine and Teaching Hospital, Hradec Králové, Czech Republic.
700    1_
$a Jandová, M $u Department of Dermatovenerology, Charles University, Faculty of Medicine and Teaching Hospital, Hradec Králové, Czech Republic.
700    1_
$a Košťál, M $u IV. Internal Haematology Department, Charles University, Faculty of Medicine and Teaching Hospital, Hradec Králové, Czech Republic.
700    1_
$a Brychta, P $u Department of Burns and Reconstructive Surgery, Teaching Hospital Brno, Czech Republic; Faculty of Medicine, Masaryk University Brno, Czech Republic.
710    2_
$a CELESTE Study Group
773    0_
$w MED00000977 $t Burns $x 1879-1409 $g Roč. 44, č. 6 (2018), s. 1551-1560
856    41
$u https://pubmed.ncbi.nlm.nih.gov/29886114 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y a $z 0
990    __
$a 20190813 $b ABA008
991    __
$a 20250603083741 $b ABA008
999    __
$a ok $b bmc $g 1433535 $s 1066846
BAS    __
$a 3
BAS    __
$a PreBMC
BMC    __
$a 2018 $b 44 $c 6 $d 1551-1560 $e 20180607 $i 1879-1409 $m Burns $n Burns $x MED00000977
LZP    __
$a Pubmed-20190813

Find record

Citation metrics

Archiving options