Background

The burden of non-invasive Group B Streptococcus (GBS) infections in adults is unknown. We determined population-based rates of hospitalization where invasive or non-invasive GBS infections were identified among US adults in a defined catchment area.

Methods

We identified adults with clinical and laboratory-confirmed evidence of GBS infection from January 2014 through December 2016 from six hospitals in Louisville, Kentucky. Invasive disease was defined as GBS isolated from a normally sterile site.

Results

Among 1076 adults with GBS infection, median age was 52 years, 51% were male, and 89% had ≥1 chronic medical condition. The most prevalent infection sites were skin and soft tissue (39%), urinary tract (23%), bone and joint (16%), and bloodstream (11%). Forty percent were polymicrobial. Annual incidence of GBS-associated hospitalization was 73 per 100,000 adults and was 68 and 100 per 100,000 for those 18–64 and ≥65 years of age, respectively. For every invasive GBS infection, 3.7 non-invasive infections occurred.

Conclusions

Our population-based study outlines the full burden of GBS-associated hospitalization in adults and found incidence rates comparable to pneumococcal disease where vaccines are recommended. Non-invasive disease was 3–4 times more common than invasive disease, suggesting that adult GBS burden is considerably greater than previously recognized.

中文翻译：

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B 组链球菌感染住院成人的负担

背景

成人非侵入性 B 组链球菌 (GBS) 感染的负担尚不清楚。我们确定了基于人群的住院率，其中在特定集水区的美国成年人中发现了侵入性或非侵入性 GBS 感染。

方法

我们从 2014 年 1 月至 2016 年 12 月从肯塔基州路易斯维尔的六家医院确定了具有 GBS 感染临床和实验室确认证据的成人。侵袭性疾病定义为从正常无菌部位分离出的 GBS。

结果

在 1076 名 GBS 感染成人中，中位年龄为 52 岁，51% 为男性，89% 患有≥1 种慢性疾病。最常见的感染部位是皮肤和软组织 (39%)、泌尿道 (23%)、骨和关节 (16%) 和血液 (11%)。40% 是多种微生物。GBS 相关住院的年发病率为每 100,000 名成人 73 例，而 18-64 岁和 65 岁以上人群分别为每 100,000 例 68 和 100 例。对于每个侵袭性 GBS 感染，发生 3.7 次非侵袭性感染。

结论

我们基于人群的研究概述了成人 GBS 相关住院的全部负担，并发现其发病率与推荐接种疫苗的肺炎球菌疾病相当。非侵袭性疾病的发病率是侵袭性疾病的 3-4 倍，这表明成人 GBS 负担比以前认识的要大得多。