Department of Infectious Diseases, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles (ULB), 322, rue Haute, 1000, Bruxelles, Belgium.
Clinic of Infectious Diseases, Cliniques Universitaires de Bruxelles Erasme, Bruxelles, Belgium.
Eur J Clin Microbiol Infect Dis. 2021 Mar;40(3):515-523. doi: 10.1007/s10096-020-04041-0. Epub 2020 Sep 17.
To assess the incidence, clinical, microbiological features and outcome of invasive Streptococcus agalactiae (GBS) infections in non-pregnant adults in three tertiary hospitals of the Brussels-Capital Region. All bacterial cultures positive for GBS, from 2005 to 2019 from 3 hospitals of the Brussels-Capital Region, were extracted, and only cases of invasive diseases were included. Medical files were retrospectively retrieved for risk factors, clinical manifestations and outcome and also antibiotic-susceptibility testing and GBS serotypes. Incidence rates were calculated based on the hospitals catchment populations. A total of 337 cases of GBS-invasive infections were included. The incidence of invasive GBS for the 3 hospitals increased from 3.7 to 8.2 cases per 100.000 inhabitants between 2009 and 2018 (p = 0.04). The most frequently identified risk factors were diabetes (36.8%), obesity (35.0%), cancer (21.7%), renal disease (20.8%), and advanced age (≥ 65 years; 47.2%). Isolated bacteremia (22%), osteoarticular infection (21.4%), abscesses (13.9%), and skin and soft tissue infections (18.4%) were the most frequent manifestations. Intensive care unit admission was required in 21.7% and overall mortality was 9.4%. All strains remained susceptible to penicillin over the years. Up to 20% of strains were resistant to clindamycin. Serotypes Ia, Ib, II, III, IV, and V represented 96.8% of the available serotypes (60/62). As reported in several countries, invasive GBS disease in non-pregnant adults represents an increasing burden, particularly among diabetic, obese, and elderly patients. Almost all serotypes identified are included in the upcoming hexavalent GBS conjugate vaccine.
评估布鲁塞尔首都大区三家三级医院中无妊娠成人侵袭性无乳链球菌（GBS）感染的发生率、临床、微生物学特征和结局。从 2005 年至 2019 年，从布鲁塞尔首都大区的 3 家医院提取了所有 GBS 阳性的细菌培养物，仅包括侵袭性疾病的病例。回顾性检索了病历，以了解危险因素、临床表现和结局，以及抗生素药敏试验和 GBS 血清型。根据医院的服务人群计算了发病率。共纳入 337 例 GBS 侵袭性感染病例。2009 年至 2018 年，3 家医院侵袭性 GBS 的发病率从每 10 万人 3.7 例增加到 8.2 例（p = 0.04）。最常见的危险因素是糖尿病（36.8%）、肥胖（35.0%）、癌症（21.7%）、肾脏疾病（20.8%）和年龄≥65 岁（47.2%）。孤立性菌血症（22%）、骨关节炎感染（21.4%）、脓肿（13.9%）和皮肤软组织感染（18.4%）是最常见的表现。21.7%的患者需要入住重症监护病房，总死亡率为 9.4%。所有菌株多年来均对青霉素保持敏感。高达 20%的菌株对克林霉素耐药。血清型 Ia、Ib、II、III、IV 和 V 占可利用血清型的 96.8%（60/62）。与几个国家的报告一样，非妊娠成人侵袭性 GBS 疾病的负担不断增加，尤其是在糖尿病、肥胖和老年患者中。几乎所有鉴定出的血清型都包含在即将推出的六价 GBS 结合疫苗中。
