Giménez M, Sopena N, Viñado B, Cardona P J, Pedro-Botet M L, Coroleu W, Arnal J
Servicio de Microbiología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona.
Enferm Infecc Microbiol Clin. 1996 May;14(5):300-3.
Streptococcus agalactiae is a known causal agent of neonatal meningitis, sepsis and puerperal infections. The incidence of invasive infections caused by Streptococcus agalactiae has increased in recent years in non gestating adults: in the elderly, patients receiving prolonged steroid treatment or those with chronic immunosuppressive diseases. The clinical and epidemiological characteristics and risk factors associated to invasive infections caused by S. agalactiae were analyzed.
A retrospective study was undertaken in patients with invasive disease by S. agalactiae attended in the Hospital Universitari Germans Trias i Pujol in Badalona (Barcelona), Spain, from 1983 to 1993.
S. agalactiae was isolated in 51 patients including 13 (25%) neonates. Three patients presented invasive puerperal infection. Thirty-five adult patients with a mean age of 62 years presented invasive disease. Infection involved bacteremia in 26 (74.2%) patients. S. agalactiae was isolated in the ascitic fluid of 4 patients with liver cirrhosis with spontaneous bacterial peritonitis (one with bacteriemia) and in the peritoneal exudate of two patients with peritonitis secondary to intestinal perforation. Of 5 patients with septic arthritis, 3 involved bacteremia. Two patients presented empyema by S. agalactiae. Mortality was 28%, being directly related with infection in 4 cases (7.8%).
Without taking pregnant women into account, 68% of the cases of invasive infections by S. agalactiae were observed in adults with associated base disease, with liver cirrhosis, neoplasms and diabetes mellitus being the most frequent. Advanced age was also found to be an important predisposing factor.
无乳链球菌是新生儿脑膜炎、败血症及产褥期感染的已知病原体。近年来，在非妊娠成年人中，由无乳链球菌引起的侵袭性感染发病率有所上升，这些成年人包括老年人、接受长期类固醇治疗的患者或患有慢性免疫抑制疾病的患者。分析了与无乳链球菌引起的侵袭性感染相关的临床、流行病学特征及危险因素。
对1983年至1993年在西班牙巴塞罗那巴达洛纳的德国人特里亚斯 - 普约尔大学医院就诊的无乳链球菌侵袭性疾病患者进行了一项回顾性研究。
51例患者分离出无乳链球菌，其中13例（25%）为新生儿。3例患者出现侵袭性产褥期感染。35例成年患者出现侵袭性疾病，平均年龄62岁。26例（74.2%）患者感染涉及菌血症。在4例肝硬化并发自发性细菌性腹膜炎患者（1例伴有菌血症）的腹水及2例肠穿孔继发腹膜炎患者的腹腔渗出液中分离出无乳链球菌。5例脓毒性关节炎患者中，3例涉及菌血症。2例患者出现无乳链球菌引起的脓胸。死亡率为28%，4例（7.8%）死亡与感染直接相关。
不考虑孕妇，68%的无乳链球菌侵袭性感染病例见于患有相关基础疾病的成年人中，其中肝硬化患者最为常见，其次是肿瘤患者和糖尿病患者。高龄也是一个重要的易感因素。
