School of Medicine, James Cook University, Townsville, Queensland, Australia.
Department of Infectious Diseases and Microbiology, Townsville University Hospital, Townsville, Queensland, Australia.
Intern Med J. 2022 May;52(5):800-807. doi: 10.1111/imj.15164.
Group B streptococcus (GBS) is a recognised perinatal and neonatal pathogen. There are reports of increasing GBS sepsis globally outside this demographic. North Queensland is part of tropical Australia, with a relatively high proportion of Indigenous Australians.
To analyse the epidemiology of GBS bacteraemia and explore associated risk factors.
This was a 10-year retrospective review of GBS bacteraemia in a tertiary facility in North Queensland, between 2010 and February 2020. Data variables collected included: demographics, risk factors, clinical source and outcomes. Multivariable logistic regression was performed to examine the association of indigenous status and other relevant clinical factors with mortality from GBS bacteraemia at 3 months.
Of the 164 total cases, 123 were not pregnancy related. The annual rate of GBS bacteraemia for the indigenous population was 12.48 per 100 000 and 4.84 per 100 000 for the non-indigenous population. Indigenous patients were more likely to have diabetes and chronic kidney disease compared with the non-indigenous patients. Males (adjusted odds ratio (AOR) = 4.34; 95% CI 1.14-16.56; P = 0.031) and immunosuppressed patients (AOR = 11.49; 95% CI 2.73-48.42; P < 0.001) were more likely to experience mortality at 3 months from GBS bacteraemia even after adjusting for other risk factors respectively.
GBS bacteraemia is deviating from being primarily a neonatal disease. While the indigenous population of North Queensland are disproportionately affected, the demographics affected differ. GBS appears to target the older non-indigenous patients with greater comorbidities. In the non-indigenous population, invasive GBS disease is an emerging issue. Three-month mortality appears to be increased in males and the immunosuppressed.
B 群链球菌（GBS）是一种公认的围产期和新生儿病原体。在这一人群之外，全球有越来越多的 GBS 败血症报告。北昆士兰是澳大利亚热带地区的一部分，其土著澳大利亚人的比例相对较高。
分析 GBS 菌血症的流行病学，并探讨相关的危险因素。
这是一项对北昆士兰一家三级医疗机构 2010 年至 2020 年 2 月期间 10 年 GBS 菌血症的回顾性研究。收集的数据变量包括：人口统计学、危险因素、临床来源和结局。采用多变量逻辑回归分析土著状态和其他相关临床因素与 GBS 菌血症 3 个月死亡率的相关性。
在 164 例总病例中，有 123 例与妊娠无关。土著人群的 GBS 菌血症年发生率为 12.48/10 万，非土著人群为 4.84/10 万。与非土著患者相比，土著患者更有可能患有糖尿病和慢性肾病。男性（调整后的优势比（AOR）=4.34；95%置信区间 1.14-16.56；P=0.031）和免疫抑制患者（AOR=11.49；95%置信区间 2.73-48.42；P<0.001）在调整其他危险因素后，3 个月时 GBS 菌血症的死亡率更高。
GBS 菌血症不再主要是一种新生儿疾病。虽然北昆士兰的土著人口受到不成比例的影响，但受影响的人群不同。GBS 似乎针对的是年龄较大、合并症较多的非土著患者。在非土著人群中，侵袭性 GBS 疾病是一个新出现的问题。男性和免疫抑制患者的 3 个月死亡率似乎更高。
