成人患 B 群链球菌感染住院的负担。
Burden of Adults Hospitalized With Group B Streptococcal Infection.
机构信息
Pfizer Vaccines, Collegeville, Pennsylvania, USA.
Division of Infectious Diseases, University of Louisville, Louisville, Kentucky, USA.
出版信息
J Infect Dis. 2021 Oct 13;224(7):1170-1178. doi: 10.1093/infdis/jiaa110.
BACKGROUND
The burden of noninvasive group B Streptococcus (GBS) infections in adults is unknown. We determined population-based rates of hospitalization where invasive or noninvasive 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 6 hospitals in Louisville, Kentucky. Invasive disease was defined as GBS isolated from a normally sterile site.
RESULTS
Among 1076 adults with GBS infection, the 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 of infections were polymicrobial. The annual incidence of GBS-associated hospitalization was 73 per 100 000 adults and 68 and 100 per 100 000 for patients aged 18-64 and ≥ 65 years, respectively. For every invasive GBS infection, 3.7 noninvasive infections occurred.
CONCLUSIONS
Our population-based study outlines the full burden of GBS-associated hospitalization in adults and found incidence rates comparable to those of pneumococcal disease, where vaccines are recommended. Noninvasive disease was 3-4 times more common than invasive disease, suggesting that the GBS burden among adults is considerably greater than previously recognized.
背景
成人无侵袭性 B 组链球菌（GBS）感染的负担尚不清楚。我们确定了在美国一个特定的集水区中，在成年人中发现侵袭性或非侵袭性 GBS 感染的基于人群的住院率。
方法
我们从肯塔基州路易斯维尔的 6 家医院确定了 2014 年 1 月至 2016 年 12 月期间有临床和实验室确诊的 GBS 感染的成年人。侵袭性疾病的定义为从正常无菌部位分离出 GBS。
结果
在 1076 名患有 GBS 感染的成年人中，中位年龄为 52 岁，51%为男性，89%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%）、骨骼和关节（16%）和血流（11%）。40%的感染为混合感染。GBS 相关住院的年发病率为每 10 万成年人 73 例，年龄在 18-64 岁和≥65 岁的患者分别为每 10 万 68 例和 100 例。每例侵袭性 GBS 感染发生 3.7 例非侵袭性感染。
结论
我们的基于人群的研究概述了成人 GBS 相关住院的全部负担，并发现发病率与推荐疫苗的肺炎球菌疾病相当。非侵袭性疾病比侵袭性疾病常见 3-4 倍，这表明成年人的 GBS 负担比以前认为的要大得多。
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