| 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
(Affiliation: Childhood and Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.)
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| Journal | Annals of internal medicine
(Ann Intern Med)
Vol. 123
Issue 6
Pg. 415-20
(Sep 15 1995)
ISSN: 0003-4819 UNITED STATES |
| PMID | 7639440
(Publication Type: Journal Article)
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| 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)
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