Risk factors for group B streptococcal disease in adults.

Abstract

OBJECTIVE:

To determine risk factors for community-acquired and nosocomial group B streptococcal disease in adults.

DESIGN:

Case-control study.

SETTING:

3 metropolitan areas in the United States with an aggregate population of 6.6 million persons.

PATIENTS:

219 nonpregnant adults with invasive group B streptococcal infection identified by a population-based surveillance in 1991 and 1992 and 645 hospital-matched controls.

RESULTS:

The following conditions were associated with a significantly increased risk for community-acquired group B streptococcal infection after controlling for age in multivariate analysis: cirrhosis (odds ratio, 9.7 [95% CI, 3.5 to 26.9]; P < 0.001), diabetes (odds ratio, 3.0 [CI, 1.9 to 4.7]; P < 0.001), stroke (odds ratio, 3.5 [CI, 1.9 to 6.4]; P < 0.001), breast cancer (odds ratio, 4.0 [CI, 1.6 to 9.8]; P = 0.002), decubitus ulcer (odd ratio, 4.0 [CI, 1.6 to 9.8]; P = 0.002), and neurogenic bladder (odds ratio, 4.6 [CI, 1.4 to 15.1]; P = 0.01). Sixty-three percent of community case-patients had at least one of these conditions. Nosocomial infection (48 cases [22%]) was independently associated with the placement of a central venous line (odds ratio, 30.9 [CI, 5.2 to 184.1]; P < 0.001), diabetes, congestive heart failure, and seizure disorder.

CONCLUSIONS:

Several chronic conditions were independently associated with group B streptococcal disease, and most case-patients had at least one of these conditions. If group B streptococcal vaccines being developed for prevention of neonatal disease are protective in adults, a vaccination strategy targeting those at highest risk has the potential to substantially reduce the burden of invasive group B streptococcal infection in adults.

• Authors: L A Jackson, R Hilsdon, M M Farley, L H Harrison, A L Reingold, B D Plikaytis, J D Wenger, A Schuchat
• Journal: Annals of internal medicine (Ann Intern Med) Vol. 123 Issue 6 Pg. 415-20 (Sep 15 1995) ISSN: 0003-4819 [Print] United States
• PMID: 7639440 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Aged, 80 and over
• Bacteremia (microbiology)
• Case-Control Studies
• Community-Acquired Infections (etiology, mortality)
• Cross Infection (etiology, mortality)
• Female
• Hospital Mortality
• Humans
• Male
• Middle Aged
• Multivariate Analysis
• Odds Ratio
• Risk Factors
• Streptococcal Infections (etiology, mortality)
• Streptococcus agalactiae (isolation & purification)
• Syndrome
• United States (epidemiology)