Francioli P, Vaudaux B, Glauser M P
Schweiz Med Wochenschr. 1983 Jan 15;113(2):38-41.
From 1976 to 1981, 28 episodes of group B streptococcus (GBS) septicemia were identified in our hospital (CHUV, University Hospital Lausanne), 18 in 17 adults and 10 in newborns. The latter had acute respiratory distress syndrome (8 cases) or meningitis (2 cases). In adults the skin was the main source of infection (6 diabetic foot, 4 acute cellulitis complicating chronic skin diseases, 2 infections secondary to diagnostic procedures (capillary and ascitic taps) and 1 meningitis secondary to neurosurgery). The other sources of infection were 1 pharyngitis, 1 pneumonia and 1 pyelonephritis. Eleven patients had an underlying disease (7 diabetes and 4 malignancies). Four patients developed septic osteoarticular metastases, one after a 3 weeks' course of antibiotic. In the latter case, as well as in the two adult patients who died, the strains of GBS were found to be tolerant to penicillin. Thus, GBS septicemia are not rare in adults and occur often in compromised hosts such as diabetics. The portal of entry is frequently the skin and the course may be severe with distant complications.
1976年至1981年期间,我院(洛桑大学医院,CHUV)共确诊28例B族链球菌(GBS)败血症病例,其中17名成人患者中有18例,新生儿患者中有10例。新生儿患有急性呼吸窘迫综合征(8例)或脑膜炎(2例)。成人患者中,皮肤是主要感染源(6例糖尿病足,4例慢性皮肤病并发急性蜂窝织炎,2例诊断性操作(毛细血管穿刺和腹水穿刺)继发感染,1例神经外科手术后并发脑膜炎)。其他感染源包括1例咽炎、1例肺炎和1例肾盂肾炎。11例患者有基础疾病(7例糖尿病和4例恶性肿瘤)。4例患者发生了感染性骨关节炎转移,其中1例在接受3周抗生素治疗后出现。在后一例以及另外两名死亡的成年患者中,发现GBS菌株对青霉素耐药。因此,GBS败血症在成人中并不罕见,且常在糖尿病等免疫功能低下的宿主中发生。感染途径通常是皮肤,病情可能较为严重,并伴有远处并发症。