Ann Clin Microbiol.  2014 Mar;17(1):9-13. 10.5145/ACM.2014.17.1.9.

Clinical Characteristics of Streptococcus agalactiae Bacteremia in Adults Living in Jeju Island

• Lee K
• Kim WJ
• Kim DL
• Ko HM
• Baik SH
• Kim MN
• Chong MS

• KMID: 1518098
• DOI: http://doi.org/10.5145/ACM.2014.17.1.9

Abstract

BACKGROUND
Streptococcus agalactiae (Group B streptococcus, GBS) is known to be the leading cause of neonatal sepsis and meningitis in the United States and Europe. In addition, GBS infection has been increasingly noted in adults, particularly in those with underlying diseases, such as diabetes mellitus, malignancy and liver disease. A few studies reported that resistances to antibiotics, such as erythromycin, clindamycin, tetracycline are increasing. We report clinical and microbiological characteristics of GBS bacteremic patients in Jeju Island.
METHODS
We retrospectively analyzed medical records, such as age, sex, underlying disease, mortality, skin defects, laboratory results and antibiotic resistances of GBS in hospitalized adult patients who were diagnosed with GBS bacteremia from 2008 to 2013 in Jeju Island.
RESULTS
Twenty two adult patients were diagnosed as GBS bacteremia from 2008 to 2013. The mean age of GBS bacteremic patients was 66.2 years old. Of 22 bacteremic patients, fifteen patients (68%) were older than 60. Twenty patients (91%) of bacteremic patients had underlying diseases such as diabetes mellitus, malignancy and liver disease. Ten (45%) patients had skin defects which were on the lower extremities and buttock, fifteen (68%) patients had fever at the time of admission, twenty one (95%) patients were admitted via the emergency department. Two (9%) patients died. The mean white blood cell (WBC) count, percentile of neutrophil count, and C-reactive protein (CRP) levels were 11,488/microL, 84.3 %, 13.5 mg/dL respectively. All GBS isolates from bacteremia showed sensitivities to penicillin, ampicillin, and vancomycin, and showed resistances to erythromycin (25%), clindamycin (30%), and tetracycline (55%).
CONCLUSION
Bacteremia caused by GBS was prevalent in adult patients with underlying diseases. Most of the GBS bacteremic patients were emergency cases, with a high body temperature, WBC, CRP level, and neutrophil count. Half of them had skin defects, which are considered a source of GBS bacteremia.

Keyword

Bacteremia; Drug resistance; Group B streptococci; Streptococcus agalactiae

MeSH Terms

Adult*
Ampicillin
Anti-Bacterial Agents
Bacteremia*
Body Temperature
Buttocks
C-Reactive Protein
Clindamycin
Diabetes Mellitus
Drug Resistance
Emergencies
Emergency Service, Hospital
Erythromycin
Europe
Fever
Humans
Leukocytes
Liver Diseases
Lower Extremity
Medical Records
Meningitis
Mortality
Neutrophils
Penicillins
Retrospective Studies
Sepsis
Skin
Streptococcus agalactiae*
Streptococcus*
Tetracycline
United States
Vancomycin
Ampicillin
Anti-Bacterial Agents
C-Reactive Protein
Clindamycin
Erythromycin
Penicillins
Tetracycline
Vancomycin

Figure

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  Fig. 1. Occurrence of Streptococcus agalactiae bacteremia according to age groups.

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