Group B streptococcus (GBS) has emerged as an important cause of invasive infection in non-pregnant adults. This study aimed to describe the clinical characteristics and risk factors associated with GBS bacteremia in non-pregnant adult patients in Korea.
Methods: Our retrospective study reviews the hospital records of non-pregnant adults, aged ≥ 18 years, with GBS bacteremia who attended the Pusan national university hospital between January 1, 2008 and December 31, 2017. Presence of underlying diseases, such as cardiovascular diseases, diabetes mellitus, malignancy, liver disease and/or alcohol abuse and renal disease, as well as possible portals of entry of infection was analyzed.
Results: During the period of 10 years, there were 79 patients with GBS bacteremia. In 47 episodes (59.5%), patients were aged 60 years or older and 43 (54.4%) episodes occurred in females. Their mean age was 61 years (range, 19-91 years) and 70 patients (88.6%) had underlying diseases. Cardiovascular diseases (n=35, 44.3%) were the most common underlying conditions, and diabetes mellitus (n=27, 34.2%) and non-hematologic malignancy (n=27, 34.2%) were second. Genitourinary cancer composed nearly half of non-hematologic malignancy (n=13, 48.1%). The other co-morbid conditions were liver disease and/or alcohol abuse (n=14, 17.7%), renal disease (n=13, 16.5%) and hematologic malignancy (n=7, 8.9%). The most common clinical syndrome was primary bacteremia (n=31, 39.2%). The others were bone and joint infection (n=15, 19.0%), urinary tract infection (n=12, 15.2%), skin and soft tissue infection (n=7, 8.9%), infective endocarditis (n=4, 5.1%), peritonitis (n=4, 5.1%) and meningitis (n=2, 2.5%). The overall mortality rate was 13.9%, all patients had at least 1 underlying disease. The mortality rate of primary bacteremia was significantly higher than those of bacteremia with focus (29.0% vs. 4.2%, respectively; p=0.002). Hematologic malignancy, liver disease and/or alcohol abuse and renal disease were significantly associated with the primary bacteremia.
Conclusion: GBS bacteremia is a significant problem in non-pregnant patients, especially primary bacteremia resulted in a high rate of mortality (29%). Hematologic malignancy, liver disease and/or alcohol abuse and renal disease were significantly related to primary bacteremia occurrence.
J. E. Lee,
S. Lee, None
K. H. Kim, None
S. O. Lee, None
Y. Sim, None