Bajnaid Nisreen, Kaki Reham
Department of Medicine, King Abdulaziz University, Jeddah, SAU.
Department of Infectious Diseases, King Abdulaziz University, Jeddah, SAU.
Cureus. 2024 Feb 19;16(2):e54442. doi: 10.7759/cureus.54442. eCollection 2024 Feb.
Background Invasive disease due to group B (GBS) infection in adult males and nonpregnant females can cause various diseases, such as primary bacteremia, endocarditis, skin and soft tissue infection (SSTI), and meningitis. Especially in older people, invasive GBS infection has a high case fatality rate. In Saudi Arabia, little is known about the clinical signs and symptoms of GBS bacteremia and the associated risk factors and mortality rate. Methodology We performed a retrospective study at King Abdulaziz University Hospital in Jeddah, Saudi Arabia, a large tertiary hospital, to investigate clinical disease, potential risk factors, susceptibility patterns, and mortality related to GBS in adult males and nonpregnant females diagnosed with GBS bacteremia. All patients ≥14 years of age with GBS-positive blood cultures from January 1, 2015, until December 31, 2022, were included. Patient data such as age, sex, comorbidities, hospital ward, length of hospital stay, monomicrobial versus polymicrobial bloodstream infection, antimicrobials used for treatment, complications, whether an infectious disease specialist had seen them, and outcomes were extracted from the electronic health records. Results A total of 50 patients with GBS bacteremia met the inclusion criteria. The mean age of these patients was 57.0 years (SD = 16.0), and 27 (54%) were female. The 90-day mortality was 11 (22%). In total, 34 (68%) patients had a monomicrobial infection, and among those with polymicrobial infection, methicillin-resistant was the most common co-infection (56%, n = 9/16). The most common source of infection was SSTI and wound infection in 24 (48%) patients. Most patients had one or more comorbidities; the mean Charlson comorbidity index was 3.8 (SD = 2.4). The most prevalent comorbidity was diabetes mellitus in 35 (70%) patients. Of all variables analyzed, only age was significantly associated with mortality (p = 0.016), and age had a predictive value for mortality (p = 0.035). Conclusions In Saudi Arabia, as in other countries, GBS is an important pathogen, especially in older people, that should be considered when encountering a patient with bacteremia. In addition, in patients over 65 years old, GBS bacteremia carries a high risk for mortality.
背景 B族链球菌（GBS）感染在成年男性和非妊娠女性中引发的侵袭性疾病可导致多种病症，如原发性菌血症、心内膜炎、皮肤和软组织感染（SSTI）以及脑膜炎。尤其是在老年人中，侵袭性GBS感染的病死率很高。在沙特阿拉伯，关于GBS菌血症的临床体征和症状、相关危险因素及死亡率的了解甚少。
方法 我们在沙特阿拉伯吉达的阿卜杜勒阿齐兹国王大学医院（一家大型三级医院）开展了一项回顾性研究，以调查确诊为GBS菌血症的成年男性和非妊娠女性中与GBS相关的临床疾病、潜在危险因素、药敏模式及死亡率。纳入了所有在2015年1月1日至2022年12月31日期间血培养GBS呈阳性且年龄≥14岁的患者。从电子健康记录中提取患者数据，如年龄、性别、合并症、医院病房、住院时间、单微生物与多微生物血流感染情况、用于治疗的抗菌药物、并发症、是否有感染病专科医生看过以及结局等。
结果 共有50例GBS菌血症患者符合纳入标准。这些患者的平均年龄为57.0岁（标准差=16.0），27例（54%）为女性。90天死亡率为11例（22%）。总共34例（68%）患者为单微生物感染，在多微生物感染患者中，耐甲氧西林金黄色葡萄球菌是最常见的合并感染菌（56%，n=9/16）。最常见的感染源是24例（48%）患者的SSTI和伤口感染。大多数患者有一项或多项合并症；查尔森合并症指数的平均值为3.8（标准差=2.4）。最常见的合并症是35例（70%）患者的糖尿病。在所有分析的变量中，只有年龄与死亡率显著相关（p=0.016），且年龄对死亡率有预测价值（p=0.035）。
结论 在沙特阿拉伯，与其他国家一样，GBS是一种重要的病原体，尤其是在老年人中，遇到菌血症患者时应予以考虑。此外，65岁以上患者的GBS菌血症死亡率很高。
