Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia.
Int J Infect Dis. 2013 Sep;17(9):e777-80. doi: 10.1016/j.ijid.2013.01.011. Epub 2013 Feb 28.
Group B Streptococcus (GBS) is a leading cause of infections such as meningitis and septicemia in neonates and pregnant women; however the significance of invasive GBS disease has not been clearly defined in non-pregnant adults.
We reviewed the hospital records of 18 cases with GBS bacteremia who attended the Universiti Kebangsaan Malaysia Medical Centre from June 2010 to October 2011. We analyzed the clinical findings of both bacteremic adults and neonates and compared them to previous studies of GBS bacteremia. Serotyping was done by latex agglutination test using 10 distinct antisera (Ia, Ib, and II-IX).
During the period of 1 year and 4 months, there were 18 patients with GBS bacteremia. Five cases occurred in neonates, one in a parturient woman, and 12 in other adults. All neonates with bacteremia were males and two of them were premature. Septicemia was the most common clinical presentation in neonates. They were treated with intravenous (IV) penicillin G and gentamicin. The adults included nine men (69%) and four women (31%). Their mean age was 60 years and all patients had more than two underlying conditions. The most common clinical syndrome was pneumonia (n=6, 46.5%). The others were peritonitis (n=3, 23.1%), primary bacteremia (n=2, 15.5%), septic arthritis (n=2, 15.5%), skin and soft tissue infection (n=1, 7.7%), meningitis (n=1, 8%), urinary tract infection (n=1, 8%), and intravascular device infection (n=1, 7.7%). Cardiovascular diseases (n=7, 53.8%) were the most common underlying conditions, and diabetes mellitus (n=5, 38.5%) was second. The other co-morbid conditions were hyperlipidemia (n=3, 23.1%), renal disease (n=3, 23.1%), liver disease and/or alcohol abuse (n=3, 23.1%), autoimmune disease or immunosuppressive condition (n=2, 15.5%), malignancy (n=2, 15.5%), respiratory disease (n=1, 8%), and postpartum condition (n=1, 8%), as well as miscellaneous conditions including intravenous drug abuse, HIV infection, and trauma (n=2, 15.5%). Polymicrobial bacteremia was found in five (45.4%) cases and Staphylococcus aureus was the most common concurrent bacterial isolate. Of the 18 GBS isolates in both adults and neonates, serotype Ia was predominant (38.9%), followed by VI (27.8%), V (11.1%), and III (5.5%); the remaining 16.7% were non-typeable.
GBS bacteremia is a significant problem and is associated with serious underlying disease, which may result in a high rate of mortality, not only in neonates and pregnant women, but also in non-pregnant adults.
B 群链球菌（GBS）是导致新生儿和孕妇脑膜炎和败血症等感染的主要原因；然而，侵袭性 GBS 疾病在非孕妇成人中的意义尚未明确。
我们回顾了 2010 年 6 月至 2011 年 10 月期间，马来西亚国民大学医学中心 18 例 GBS 菌血症患者的住院记录。我们分析了菌血症成人和新生儿的临床发现，并与以前的 GBS 菌血症研究进行了比较。血清型鉴定采用 10 种不同抗血清（Ia、Ib 和 II-IX）进行乳胶凝集试验。
在 1 年零 4 个月的时间里，共有 18 例 GBS 菌血症患者。5 例发生在新生儿，1 例发生在产妇，12 例发生在其他成人。所有患有菌血症的新生儿均为男性，其中 2 例为早产儿。败血症是新生儿最常见的临床表现。他们接受了静脉（IV）青霉素 G 和庆大霉素治疗。成人包括 9 名男性（69%）和 4 名女性（31%）。他们的平均年龄为 60 岁，所有患者均有两种以上的基础疾病。最常见的临床综合征是肺炎（n=6，46.5%）。其他还有腹膜炎（n=3，23.1%）、原发性菌血症（n=2，15.5%）、化脓性关节炎（n=2，15.5%）、皮肤和软组织感染（n=1，7.7%）、脑膜炎（n=1，8%）、尿路感染（n=1，8%）和血管内装置感染（n=1，7.7%）。心血管疾病（n=7，53.8%）是最常见的基础疾病，其次是糖尿病（n=5，38.5%）。其他合并症包括高脂血症（n=3，23.1%）、肾脏疾病（n=3，23.1%）、肝脏疾病和/或酒精滥用（n=3，23.1%）、自身免疫性疾病或免疫抑制状况（n=2，15.5%）、恶性肿瘤（n=2，15.5%）、呼吸道疾病（n=1，8%）和产后状况（n=1，8%），以及包括静脉药物滥用、HIV 感染和创伤在内的其他混杂情况（n=2，15.5%）。五例（45.4%）发现混合菌血症，最常见的合并细菌分离株为金黄色葡萄球菌。在成人和新生儿的 18 株 GBS 分离株中，血清型 Ia 占优势（38.9%），其次是 VI（27.8%）、V（11.1%）和 III（5.5%）；其余 16.7%为非定型。
GBS 菌血症是一个严重的问题，与严重的基础疾病有关，这可能导致高死亡率，不仅在新生儿和孕妇中，而且在非孕妇成人中也是如此。
