Group B streptococcus infections of soft tissue and bone in California adults, 1995–2012

SUMMARYGroup B streptococcus (GBS) is an increasing cause of disease in adults. We present long-term trends in incidence of overall infections and identify characteristics of patients with GBS cellulitis, bone and joint infections. Active, population-based surveillance was conducted from 1995–2012 in three California counties and the data were analysed retrospectively. All cases had isolation of GBS from a normally sterile site. Cases of cellulitis were classified based on clinical diagnosis. GBS bone or joint infection was defined as isolation of GBS from a bone or joint or a diagnosis of osteomyelitis or septic arthritis. Medical charts were reviewed for demographic and clinical information. There were 3917 cases of GBS; the incidence of disease increased from 5·8 to 8·3 cases/100 000 persons (P < 0·001) from 1995 to 2012. In adults aged ⩾40 years, the overall incidence of GBS increased from 8·5 to 14·2 cases/100 000 (P < 0·001) persons during the study period. The incidence of cellulitis increased from 1·6 to 3·8 cases/100 000 (P < 0·001), bone infection increased from 0·7 to 2·6 cases/100 000 (P < 0·001), and the incidence of joint infection remained approximately constant at an average rate of 1·0 case/100 000. The highest incidence rates were observed in men, persons aged ⩾80 years, non-Hispanic blacks and Hispanics. Diabetes was the most common underlying condition (51·2% cellulitis cases, 76·3% bone infections, 29·8% joint infections).

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Burden of Adults Hospitalized With Group B Streptococcal Infection

The Journal of Infectious Diseases ◽

10.1093/infdis/jiaa110 ◽

2020 ◽

Cited By ~ 2

Author(s):

John M McLaughlin ◽

Paula Peyrani ◽

Stephen Furmanek ◽

Farid L Khan ◽

Angela Quinn ◽

...

Keyword(s):

Pneumococcal Disease ◽

Medical Condition ◽

Group B Streptococcus ◽

Invasive Disease ◽

Population Based ◽

Incidence Rates ◽

Chronic Medical Condition ◽

Population Based Study ◽

Sterile Site ◽

Group B

Abstract Background The burden of noninvasive group B Streptococcus (GBS) infections in adults is unknown. We determined population-based rates of hospitalization where invasive or noninvasive GBS infections were identified among US adults in a defined catchment area. Methods We identified adults with clinical and laboratory-confirmed evidence of GBS infection from January 2014 through December 2016 from 6 hospitals in Louisville, Kentucky. Invasive disease was defined as GBS isolated from a normally sterile site. Results Among 1076 adults with GBS infection, the median age was 52 years, 51% were male, and 89% had ≥1 chronic medical condition. The most prevalent infection sites were skin and soft tissue (39%), urinary tract (23%), bone and joint (16%), and bloodstream (11%). Forty percent of infections were polymicrobial. The annual incidence of GBS-associated hospitalization was 73 per 100 000 adults and 68 and 100 per 100 000 for patients aged 18–64 and ≥ 65 years, respectively. For every invasive GBS infection, 3.7 noninvasive infections occurred. Conclusions Our population-based study outlines the full burden of GBS-associated hospitalization in adults and found incidence rates comparable to those of pneumococcal disease, where vaccines are recommended. Noninvasive disease was 3–4 times more common than invasive disease, suggesting that the GBS burden among adults is considerably greater than previously recognized.

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Population-based surveillance for bacterial meningitis in the Dominican Republic: implications for control by vaccination

Epidemiology and Infection ◽

10.1017/s0950268800004830 ◽

2000 ◽

Vol 125 (3) ◽

pp. 549-554 ◽

Cited By ~ 3

Author(s):

E. GOMEZ ◽

M. PEGUERO ◽

J. SANCHEZ ◽

P. L. CASTELLANOS ◽

J. FERIS ◽

...

Keyword(s):

Bacterial Meningitis ◽

Dominican Republic ◽

Group B Streptococcus ◽

Case Series ◽

Population Based ◽

Incidence Rates ◽

World Health ◽

Laboratory Methods ◽

Group B ◽

Health Organization

Quantifying the local burden of disease is an important step towards the introduction of new vaccines, such as Haemophilus influenzae type b (Hib) conjugate vaccine. We adapted a generic protocol developed by the World Health Organization for population-based surveillance of bacterial meningitis. All hospitals that admit paediatric patients with meningitis in the National District, Dominican Republic were included in the system and standard laboratory methods were used. The system identified 111 cases of confirmed bacterial meningitis. Hib was the leading cause of bacterial meningitis, followed by group B streptococcus, S. pneumoniae, and N. meningitidis. Unlike hospital-based case series, this population-based system was able to calculate incidence rates. The incidence of Hib meningitis was 13 cases per 100 000 children < 5 years old. The data from this study were used by the Ministry of Health to support the introduction of routine Hib vaccination and will be used to monitor its effectiveness.

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Characteristics of Group B Streptococcus Isolated from Infants with Invasive Infections: A Population-Based Study in Japan

Japanese Journal of Infectious Diseases ◽

10.7883/yoken.67.356 ◽

2014 ◽

Vol 67 (5) ◽

pp. 356-360 ◽

Cited By ~ 13

Author(s):

Bin Chang ◽

Akihito Wada ◽

Mitsuaki Hosoya ◽

Tomohiro Oishi ◽

Naruhiko Ishiwada ◽

...

Keyword(s):

Group B Streptococcus ◽

Population Based ◽

Population Based Study ◽

Invasive Infections ◽

Group B

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732: Group B Streptococcus maternal colonization and future respiratory infections in the offspring: Results from a population based cohort of up to 18 years follow-up

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2017.11.263 ◽

2018 ◽

Vol 218 (1) ◽

pp. S440

Author(s):

Shirley Greenbaum ◽

Eyal Sheiner ◽

Tamar Wainstock ◽

Idit Segal ◽

Jacob Moran-Gilad ◽

...

Keyword(s):

Respiratory Infections ◽

Group B Streptococcus ◽

Population Based ◽

Group B

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The epidemiology of pituitary adenomas in Iceland, 1955–2012: a nationwide population-based study

Acta Endocrinologica ◽

10.1530/eje-15-0189 ◽

2015 ◽

Vol 173 (5) ◽

pp. 655-664 ◽

Cited By ~ 110

Author(s):

Tomas Thor Agustsson ◽

Tinna Baldvinsdottir ◽

Jon G Jonasson ◽

Elinborg Olafsdottir ◽

Valgerdur Steinthorsdottir ◽

...

Keyword(s):

Pituitary Adenomas ◽

Incidental Findings ◽

Disease Burden ◽

Clinical Information ◽

Population Based ◽

Incidence Rates ◽

Allocation Of Resources ◽

Population Based Study ◽

Total Prevalence ◽

Clinically Significant

ObjectivePituitary adenomas (PA) are among the most common human neoplasms. To describe the epidemiology and assess the disease burden of clinically significant PAs, population-based studies are needed. Iceland has a small well-defined population. The aim of this study is to describe the epidemiology of PAs in Iceland over an expanded period of time.DesignThis is a retrospective observational study, including all PAs diagnosed in Iceland from 1955 to 2012.MethodsExtensive clinical information was gathered in a database. Prevalence rates for all PA subtypes were calculated along with standardized incidence rates (SIR). Sex ratios and relationships with adenoma size, age, and symptoms were assessed.ResultsWe identified 471 individuals: 190 men and 281 women. Total prevalence in 2012 was 115.57/100 000, prolactinomas were most prevalent (54.37/100 000) followed by non-functioning adenomas (NFPAs) (42.32/100 000). Throughout the period, NFPAs were most common (43.0%) followed by prolactinomas (39.9%) and 11.3% had acromegaly and 5.7% Cushing's disease. Women are diagnosed younger with smaller adenomas. Total SIR has increased significantly and is now 5.8/100 000 per year.ConclusionIn this nationwide study spanning six decades, we have confirmed PAs rising prevalence and incidence rates noted in recent studies. We demonstrated higher overall prevalence and incidence rates than ever previously recorded with an increasing predominance of NFPAs, which is not explained by incidental findings alone. There is a relationship with the introduction of imaging modalities, but the vast majority of patients are symptomatic at diagnosis. This underlines the importance of increased awareness, education, and appropriate allocation of resources for this growing group of patients.

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Prosthetic hip-joint infection associated with a penicillin-tolerant group B streptococcus

Journal of Infection ◽

10.1016/0163-4453(92)93609-t ◽

1992 ◽

Vol 25 (1) ◽

pp. 77-81 ◽

Cited By ~ 11

Author(s):

R. Cunningham ◽

C. Walker ◽

E. Ridgway

Keyword(s):

Hip Joint ◽

Joint Infection ◽

Group B Streptococcus ◽

Group B

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Antibiotic Resistance Patterns in Invasive Group B Streptococcal Isolates

Infectious Diseases in Obstetrics and Gynecology ◽

10.1155/2008/727505 ◽

2008 ◽

Vol 2008 ◽

pp. 1-5 ◽

Cited By ~ 65

Author(s):

Mei L. Castor ◽

Cynthia G. Whitney ◽

Kathryn Como-Sabetti ◽

Richard R. Facklam ◽

Patricia Ferrieri ◽

...

Keyword(s):

Susceptibility Testing ◽

Population Based ◽

Beta Lactams ◽

Erythromycin Resistance ◽

Invasive Group ◽

Inducible Clindamycin Resistance ◽

Active Population ◽

Resistance Patterns ◽

Group B ◽

Antibiotic Resistance Patterns

Antibiotics are used for both group B streptococcal (GBS) prevention and treatment. Active population-based surveillance for invasive GBS disease was conducted in four states during 1996—2003. Of 3813 case-isolates, 91.0% (3471) were serotyped, 77.1% (2937) had susceptibility testing, and 46.6% (3471) had both. All were sensitive to penicillin, ampicillin, cefazolin, cefotaxime, and vancomycin. Clindamycin and erythromycin resistance was 12.7% and 25.6%, respectively, and associated with serotype V (P<.001). Clindamycin resistance increased from 10.5% to 15.0% (X2for trend 12.70;P<.001); inducible clindamycin resistance was associated with theermgenotype. Erythromycin resistance increased from 15.8% to 32.8% (X2for trend 55.46;P<.001). While GBS remains susceptible to beta-lactams, resistance to alternative agents such as erythromycin and clindamycin is an increasing concern.

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1761. Effect of Carbapenem-Resistant Enterobacteriaceae (CRE) Surveillance Case Definition Change on CRE Epidemiology—Selected US Sites, 2015–2016

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy209.146 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S61-S62

Author(s):

Nadezhda Duffy ◽

Sandra N Bulens ◽

Hannah Reses ◽

Maria S Karlsson ◽

Uzma Ansari ◽

...

Keyword(s):

Census Data ◽

Clinical Laboratory ◽

Population Based ◽

Incidence Rates ◽

Case Definition ◽

Emerging Infections ◽

Convenience Sample ◽

Active Population ◽

Carbapenem Resistant ◽

Before And After

Abstract Background Carbapenem-resistant Enterobacteriacae (CRE) are an urgent US public health threat. CDC reported CRE incidence to be 2.93/100,000 population in 2012–2013 in selected sites but changed the CRE surveillance case definition in 2016 to improve sensitivity for detecting carbapenemase-producing (CP) CRE. We describe CRE epidemiology before and after the change. Methods Eight CDC Emerging Infections Program sites (CO, GA, MD, MN, NM, NY, OR, TN) conducted active, population-based CRE surveillance in selected counties. A case was defined as having an isolate of E. coli, Enterobacter, or Klebsiella meeting a susceptibility phenotype (figure) at a clinical laboratory from urine or a normally sterile body site in a surveillance area resident in a 30-day period. We collected data from medical records and defined cases as community-associated (CA) if no healthcare risk factors were documented. A convenience sample of isolates were tested for carbapenemase genes at CDC by real-time PCR. We calculated incidence rates (per 100,000 population) by using US Census data. Case epidemiology and the proportion of CP-CRE isolates in 2015 versus 2016 were compared. Results In total, 442 incident CRE cases were reported in 2015, and 1,149 cases were reported in 2016. Most isolates were cultured from urine: 87% in 2015 and 92% in 2016 (P < .001). The crude overall pooled mean incidence in 2015 was 2.9 (range by site: 0.45–7.19) and in 2016 was 7.48 (range: 3.13–15.95). The most common CRE genus was Klebsiella (51%) in 2015, and in 2016 was Enterobacter (41%, P < 0.001). Of the subset of CRE isolates tested at CDC, 109/227 (48%) were CP-CRE in 2015 and 109/551 (20%) were CP-CRE in 2016. In 2015, 52/442 (12%) of cases were CA CRE, and in 2016, 267/1,149 (23%) were CA CRE (P < 0.001). In 2016, 3/111 (2.7%) of CA CRE isolates tested were CP-CRE. Conclusion A large increase in reported CRE incidence was observed after the change in the case definition. The new case definition includes a substantially larger number of Enterobacter cases. A decrease in CP-CRE prevalence appears to be driven by an increase in non-CP-CRE cases. Although CP-CRE in the community still appear to be rare, a substantial proportion of phenotypic CRE appear to be CA, and CDC is undertaking efforts to further investigate CA CRE, including CP-CRE. Disclosures G. Dumyati, Seres: Scientific Advisor, Consulting fee.

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