Domingo P, Barquet N, Alvarez M, Coll P, Nava J, Garau J
Department of Internal Medicine, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Clin Infect Dis. 1997 Nov;25(5):1180-7. doi: 10.1086/516094.
Group B streptococcus (GBS) is the leading etiologic agent of bacterial meningitis and sepsis during the neonatal period, but it is an infrequent cause of meningitis in adults. We report 12 episodes of group B streptococcal meningitis in adults and review 52 cases reported in the literature. A total of 24 men and 40 women were included in the study; the mean age (+/- SD) was 49.2 +/- 20.5 years (range, 17-89 years). All the patients had cerebrospinal fluid cultures positive for GBS. Eighty-six percent of the patients had comorbid conditions, 50% had a distant focus of infection, and blood cultures yielded GBS for 78.7%. The overall case-fatality rate was 34.4% (22 patients). Factors associated with a poor outcome were advanced mean age (+/- SD) (61.5 +/- 17.4 years vs. 42.8 +/- 19.2 years; P = .0003) and the presence of complications on admission (P = .0001). Seven percent of survivors had neurological sequelae. Group B streptococcal meningitis in adults has become increasingly frequent in recent years; it tends to occur in patients with severe underlying conditions and is associated with a high case-fatality rate. Factors associated with a poor prognosis are advanced age and the occurrence of neurological and extraneurological complications.
B族链球菌（GBS）是新生儿期细菌性脑膜炎和败血症的主要病原体，但在成人中是脑膜炎的罕见病因。我们报告了12例成人B族链球菌脑膜炎病例，并回顾了文献中报道的52例病例。该研究共纳入24名男性和40名女性；平均年龄（±标准差）为49.2±20.5岁（范围17 - 89岁）。所有患者脑脊液培养GBS均呈阳性。86%的患者有合并症，50%有远处感染灶，78.7%的血培养检出GBS。总体病死率为34.4%（22例患者）。与预后不良相关的因素是平均年龄较大（±标准差）（61.5±17.4岁对42.8±19.2岁；P = 0.0003）和入院时存在并发症（P = 0.0001）。7%的幸存者有神经后遗症。近年来成人B族链球菌脑膜炎越来越常见；它往往发生在有严重基础疾病的患者中，且病死率高。与预后不良相关的因素是年龄较大以及发生神经和神经外并发症。
