485. Recurrent Group B Streptococcus (GBS) Infections among Non-Pregnant Adults, Minnesota (MN), 1998-2009
Session: Poster Abstract Session: Public Health
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Background: Although invasive GBS disease (GBS) incidence is highest in infants, GBS in non-pregnant adults accounted for 86% of all GBS during 1998-2009.  The incidence of GBS and recurrent GBS increased over the past 12 years in MN. We examined clinical and epidemiological characteristics of recurrent GBS among non-pregnant adults. 

Methods: As part of the CDC Active Bacterial Core Surveillance (ABCs), the MN Dept. of Health conducts active, population-based surveillance among MN residents with GBS isolated from a normally sterile body site.  Recurrent cases were defined as GBS occurring ≥ 30 days and < 3 years after initial GBS culture in the same person. The Cochran-Armitage test for trend was used to assess changes in proportions by 3-year intervals.

Results: 3,342 cases of GBS in non-pregnant adults were detected during 1998-2009 (median age, 64 years).  From 1998-2000 to 2007-09, there was a significant increase in GBS incidence from 5.67 to 9.15 cases/100,000 persons (x2 for trend: p < 0.001). The proportion of GBS cases with diabetes increased significantly over time, from 27% during 1998-2000 to 45% during 2007-09 (trend: z= -6.08, 2-sided p < 0.001). Among all GBS cases, 164 cases had ≥ 1 GBS recurrence; 43% ≤ 6 months, 58% ≤1 year, and 84% ≤2 years of initial infection. The incidence of recurrent GBS significantly increased from 0.31 to 0.53 cases/100,000 persons during 1998-2000 to 2007-09 (x2 for trend: p = 0.003).

The most common GBS infections for both recurrent and non-recurrent cases were bacteremia without focus, cellulitis, and osteomyelitis/septic arthritis.  Among recurrent GBS, 50% (82/164) had a different second infection type; the most common was bacteremia/cellulitis and bacteremia/pneumonia.  The proportion of recurrent GBS cases with diabetes significantly increased over time, from 26% during 1998-2000 to 54% during 2007-09 (trend: z = -2.54, 2-sided p = 0.01).  There were no significant changes over time of recurrent GBS associated with age, sex, or long term care. 

Conclusion: Recurrent GBS has increased since 1998, especially among GBS patients with diabetes.  Continued surveillance is necessary to monitor this trend. Those with underlying conditions such as diabetes may be at risk for recurrent GBS disease and should be monitored carefully.

Corinne Holtzman, MPH, Catherine Lexau, PhD, MPH, RN, Kathryn Como-Sabetti, MPH, Richard Danila, PhD MPH and Ruth Lynfield, MD, Minnesota Department of Health, St. Paul, MN

Disclosures:

C. Holtzman, None

C. Lexau, None

K. Como-Sabetti, None

R. Danila, None

R. Lynfield, None

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