Increasing Burden of Invasive Group B Streptococcal Disease in Nonpregnant Adults, 1990–2007

June 21, 2009 at 8:26 pm Leave a comment

Clinical Infectious Diseases  July 1, 2009  V.49  N.1  p.85–92

Tami H. Skoff,1 Monica M. Farley,2,3 Susan Petit,4 Allen S. Craig,5 William Schaffner,6 Ken Gershman,7 Lee H. Harrison,8 Ruth Lynfield,9 Janet Mohle-Boetani,10 Shelley Zansky,11 Bernadette A. Albanese,12 Karen Stefonek,13 Elizabeth R. Zell,1 Delois Jackson,1 Terry Thompson,1 and

Stephanie J. Schrag1

1Respiratory Diseases Branch, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 2Emory University School of Medicine and 3Atlanta Veterans Affairs Medical Center, Atlanta, Georgia; 4Connecticut Department of Public Health, Hartford; 5Tennessee Department of Health and 6Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee; 7Colorado Department of Public Health and Environment, Denver; 8Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; 9Minnesota Department of Health, St. Paul; 10California Department of Health Services, Berkeley; 11New York State Department of Health, Albany; 12New Mexico Department of Health, Santa Fe; and 13Oregon Department of Human Services, Portland

Background. Group B Streptococcus (GBS), traditionally considered to be a neonatal pathogen, is an important cause of morbidity and mortality among older adults and among those with underlying medical conditions. We used population-based surveillance to examine trends in adult GBS disease during the period 1990–2007 and to describe the epidemiology of adult GBS disease to guide prevention efforts.

Methods. Active Bacterial Core surveillance was conducted in selected counties in 10 US states. A case was defined as isolation of GBS from a normally sterile site in a nonpregnant resident of a surveillance area who was 18 years of age. Rates were calculated using US Census data. Demographic and clinical information was abstracted from medical records. Serotyping and susceptibility testing were performed on isolates collected from a subset of case patients.

Results. A total of 19,512 GBS cases were identified in nonpregnant adults during 1990–2007 (median patient age, 63 years); the incidence of adult GBS disease doubled from 3.6 cases per 100,000 persons during 1990 to 7.3 cases per 100,000 persons during 2007 ( ). The mean difference in incidence between black and white persons was 4.6 cases per 100,000 persons (range, 3.1 cases per 100,000 persons during 1991 to 5.8 cases per 100,000 persons during 1999). Common clinical syndromes in 2007 included bacteremia without focus (39.3%), skin and/or soft-tissue infection (25.6%), and pneumonia (12.6%). Most (88.0%) GBS cases in adults had 1 underlying condition; diabetes was present in 44.4% of cases. Serotypes V, Ia, II, and III accounted for 80.8% of infections during 1998–1999 and 78.5% of infections during 2005–2006.

Conclusions. Invasive GBS disease in nonpregnant adults represents a substantial and increasing burden, particularly among older persons, black persons, and adults with diabetes. Prevention strategies are needed.

abstract

http://www.journals.uchicago.edu/doi/abs/10.1086/599369

Entry filed under: Antimicrobianos, Bacterias, Bacteriemias, Epidemiología, Infecciones emergentes, Infecciones en diabeticos, Infecciones en seniles, Metodos diagnosticos, Sepsis.

Clinical Practice Guidelines for the Diagnosis and Management of Intravascular Catheter-Related Infection: 2009 Update by the Infectious Diseases Society of America Recomendaciones y Guías de la Sociedad Argentina de Infectología – SADI –

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