Document Detail

A population-based assessment of invasive disease due to group B Streptococcus in nonpregnant adults.
MedLine Citation:
PMID:  8502269     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Group B streptococci (Streptococcus agalactiae) are a major cause of meningitis and septicemia in neonates and pregnant women, but the importance of group B streptococcal disease in nonpregnant adults has not been clearly defined. METHODS: We conducted a prospective surveillance of the pathogens responsible for meningitis for a period of 24 months in 35 hospitals and a referral laboratory in metropolitan Atlanta. We reviewed the clinical and laboratory records of all the nonpregnant adults identified as having invasive group B streptococcal disease during this period. RESULTS: During 1989 and 1990 there were 424 patients with invasive group B streptococcal disease (annual incidence, 9.2 cases per 100,000 population). Of these patients, 46 percent were 1 month of age or younger, 6 percent were older than 1 month but younger than 18 years of age, and 48 percent were 18 or older. Men and nonpregnant women accounted for 68 percent (n = 140) of all cases among adults (annual incidence, 4.4 per 100,000). Clinical and laboratory records were available for 137. In the nonpregnant adult patients (age, 18 to 99 years), the most common clinical diagnoses were skin, soft-tissue, or bone infection (in 36 percent); bacteremia with no identified source (30 percent); urosepsis (14 percent); pneumonia (9 percent); and peritonitis (7 percent). Risk factors included older age (> or = 60 years), the presence of diabetes mellitus, the presence of malignant neoplasms, and infection with the human immunodeficiency virus. The mortality rate in nonpregnant adults was 21 percent, accounting for 67 percent of all deaths related to group B streptococcal infection during the surveillance period. CONCLUSIONS: Invasive group B streptococcal infection is a major problem not only in pregnant women and neonates but also in nonpregnant adults, especially those who are elderly and those who have chronic diseases.
M M Farley; R C Harvey; T Stull; J D Smith; A Schuchat; J D Wenger; D S Stephens
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The New England journal of medicine     Volume:  328     ISSN:  0028-4793     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  1993 Jun 
Date Detail:
Created Date:  1993-06-29     Completed Date:  1993-06-29     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1807-11     Citation Subset:  AIM; IM; X    
Department of Medicine, Emory University School of Medicine, Atlanta, GA.
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MeSH Terms
AIDS-Related Opportunistic Infections
African Continental Ancestry Group
Age Factors
Aged, 80 and over
Bacteremia / epidemiology,  etiology
Middle Aged
Opportunistic Infections
Prospective Studies
Risk Factors
Skin Diseases, Bacterial / epidemiology,  etiology
Streptococcal Infections / epidemiology*,  ethnology,  etiology
Streptococcus agalactiae*
Comment In:
N Engl J Med. 1993 Jun 24;328(25):1843-4   [PMID:  8502275 ]
N Engl J Med. 1993 Nov 25;329(22):1658; author reply 1659   [PMID:  8232448 ]
N Engl J Med. 1993 Nov 25;329(22):1658-9   [PMID:  8232449 ]

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