# Clinical Aspects and Disease Severity of Streptococcus dysgalactiae Subspecies equisimilis Bacteremia, Finland

## TL;DR

This study analyzed 159 cases of SDSE bacteremia in Finland to understand disease severity and clinical outcomes.

## Contribution

The study identifies clinical predictors of severe disease and death in SDSE bacteremia patients.

## Key findings

- Cellulitis was linked to nonsevere disease, while necrotizing fasciitis was linked to severe disease.
- Blood leukocyte counts and C-reactive protein levels on specific days predicted severe disease.
- The Pitt bacteremia score accurately predicted death in SDSE bacteremia patients.

## Abstract

We conducted a prospective study of 159 cases of Streptococcus dysgalactiae subspecies equisimilis (SDSE) bacteremia in 157 patients at 2 hospitals in Finland during November 2015–November 2019. Cellulitis was associated with nonsevere disease (p = 0.008); necrotizing fasciitis was associated with severe disease (p = 0.004). Fifty percent of patients had >1 clinical characteristic associated with risk for death. The case-fatality rate was 6%, and 7% of patients were treated in an intensive care unit. Blood leukocyte counts on days 2 (p = 0.032) and 3 (p = 0.020) and C-reactive protein levels on days 3 (p = 0.030) and 4 (p = 0.009) after admission were predictors of severe disease. The Pitt bacteremia score was an accurate predictor of death. Using the Pitt bacteremia score, leukocyte counts, and CRP responses during initial treatment can improve treatment strategies and survival for patients with SDSE.