非妊娠成年人群侵袭性无乳链球菌感染

[Invasive Streptococcus agalactiae infections in non-pregnant adults].

作者信息

Lefebvre N, Forestier E, Mohseni-Zadeh M, Remy V, Lesens O, Kuhnert C, Poindron V, Riegel P, Piémont Y, Christmann D, Hansmann Y

机构信息

Service des maladies infectieuses et tropicales, centre hospitalier universitaire de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France.

出版信息

Med Mal Infect. 2007 Dec;37(12):796-801. doi: 10.1016/j.medmal.2007.04.003. Epub 2007 Jul 12.

DOI:10.1016/j.medmal.2007.04.003

PMID:17629430

Abstract

OBJECTIVES

Streptococcus agalactiae (Group B streptococcus) is a major cause of invasive diseases in non-pregnant adults, particularly in the elderly and those with underlying conditions. We describe these conditions and clinical characteristics of patients followed in our teaching hospital.

METHODS

We retrospectively reviewed clinical records of 64 patients with S. agalactiae-related invasive infection, hospitalized between January 1997 and January 2006.

RESULTS

The mean age of patients was 59 (+/-17 years). The H:F sex ratio was 1.06. At least one underlying condition was found in 90.6%. Diabetes mellitus (43.7%), peripheral vascular disease (34.4%), myocardial ischemia (20.3%) and malignant neoplasms (20.3%) were among the most frequent conditions. The mean index of comorbidity (Charlson) was 2.5 (+/-2). Common clinical manifestations included infection of the urinary tract (32.8%), skin and soft-tissue (25%), and osteoarthritis (21.9%). Bacteremia occurred in 31.2% with no identified source in 2 patients. During the first month, 2 cases of endocarditis, 1 case of meningitis, and 4 deaths occurred.

CONCLUSION

We confirm the importance of underlying diseases in the emergence of S. agalactiae infections.

摘要

目的

无乳链球菌（B族链球菌）是非妊娠成人侵袭性疾病的主要病因，尤其是在老年人和有基础疾病的人群中。我们描述了在我们教学医院就诊的患者的这些情况和临床特征。

方法

我们回顾性分析了1997年1月至2006年1月期间住院的64例无乳链球菌相关侵袭性感染患者的临床记录。

结果

患者的平均年龄为59岁（±17岁）。男女比例为1.06。90.6%的患者至少有一种基础疾病。糖尿病（43.7%）、外周血管疾病（34.4%）、心肌缺血（20.3%）和恶性肿瘤（20.3%）是最常见的基础疾病。合并症平均指数（Charlson）为2.5（±2）。常见临床表现包括尿路感染（32.8%）、皮肤和软组织感染（25%）以及骨关节炎（21.9%）。31.2%的患者发生菌血症，2例患者未发现明确感染源。在第一个月内，发生2例心内膜炎、1例脑膜炎，4例死亡。