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Group B streptococcal bacteremia in non-pregnant adults: results from two Korean centers

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Abstract

Patients with liver cirrhosis (LC) have impaired immunity and are, thus, predisposed to infection. Few studies have attempted to evaluate group B streptococcal (GBS) bacteremia in LC patients. A retrospective study of patients with GBS bacteremia was performed at the Dongguk University Ilsan Hospital and National Health Insurance Service Ilsan Hospital over a 13-year period (October 2000 to July 2013). During the study period, 97 patients with GBS bacteremia were enrolled. The median age of the patients was 67 years and 54 % were men. Among them, 23 (24 %) patients were classified as LC patients. The 30-day mortality rate of LC patients was significantly higher than that of patients with other diseases (26 % vs. 8 %, p = 0.03). The multivariate analysis indicated that LC was associated with an increased risk of 30-day mortality [hazard ratio (HR) 5.0; 95 % confidence interval (CI) 1.53–16.3; p = 0.008], as well as age (HR 1.07; 95 % CI 1.03–1.13; p = 0.02) and high Pitt bacteremia score (HR 1.23; 95 % CI 1.02–1.46; p = 0.03). The probability of survival at day 30 was significantly different for the Child–Pugh class C and the Child–Pugh classes A or B (44 % vs. 93 %, respectively; p = 0.01 by the log-rank test). The mortality rates of LC patients with GBS bacteremia were significantly higher than those of patients with other diseases. The severity of hepatic dysfunction plays an important role in the development of adverse events. Cirrhosis-specific scores such as the Child–Pugh class might be useful for predicting the prognosis of GBS bacteremia in LC patients.

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References

  1. Zangwill KM, Schuchat A, Wenger JD (1992) Group B streptococcal disease in the United States, 1990: report from a multistate active surveillance system. MMWR CDC Surveill Summ 41(6):25–32

    PubMed  CAS  Google Scholar 

  2. Skoff TH, Farley MM, Petit S, Craig AS, Schaffner W, Gershman K et al (2009) Increasing burden of invasive group B streptococcal disease in nonpregnant adults, 1990–2007. Clin Infect Dis 49(1):85–92

    Article  PubMed  Google Scholar 

  3. Jackson LA, Hilsdon R, Farley MM, Harrison LH, Reingold AL, Plikaytis BD et al (1995) Risk factors for group B streptococcal disease in adults. Ann Intern Med 123(6):415–420

    Article  PubMed  CAS  Google Scholar 

  4. Christou L, Pappas G, Falagas ME (2007) Bacterial infection-related morbidity and mortality in cirrhosis. Am J Gastroenterol 102(7):1510–1517

    Article  PubMed  Google Scholar 

  5. Cho SY, Kang CI, Kim J, Joo EJ, Ha YE, Chung DR et al (2013) Association of liver cirrhosis with group B streptococcal bacteremia in non-pregnant adults. J Infect 67(6):617–619

    Article  PubMed  Google Scholar 

  6. Huang PY, Lee MH, Yang CC, Leu HS (2006) Group B streptococcal bacteremia in non-pregnant adults. J Microbiol Immunol Infect 39(3):237–241

    PubMed  Google Scholar 

  7. Kim BN, Bae IG, Kim MN, Woo JH, Ryu J, Kim YS (2001) Group B streptococcal bacteremia in nonpregnant adults with hepatic disease in Korea. Eur J Clin Microbiol Infect Dis 20(9):639–642

    PubMed  CAS  Google Scholar 

  8. Terra C, Guevara M, Torre A, Gilabert R, Fernández J, Martín-Llahí M et al (2005) Renal failure in patients with cirrhosis and sepsis unrelated to spontaneous bacterial peritonitis: value of MELD score. Gastroenterology 129(6):1944–1953

    Article  PubMed  Google Scholar 

  9. Durand F, Valla D (2008) Assessment of prognosis of cirrhosis. Semin Liver Dis 28(1):110–122

    Article  PubMed  CAS  Google Scholar 

  10. Park HJ, Lee YM, Bang KM, Park SY, Moon SM, Park KH et al (2012) Clinical significance of Staphylococcus aureus bacteremia in patients with liver cirrhosis. Eur J Clin Microbiol Infect Dis 31(12):3309–3316

    Article  PubMed  CAS  Google Scholar 

  11. Viasus D, Garcia-Vidal C, Castellote J, Adamuz J, Verdaguer R, Dorca J et al (2011) Community-acquired pneumonia in patients with liver cirrhosis: clinical features, outcomes, and usefulness of severity scores. Medicine (Baltimore) 90(2):110–118

    Article  Google Scholar 

  12. Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40(5):373–383

    Article  PubMed  CAS  Google Scholar 

  13. McCabe WR, Jackson GG (1962) Gram-negative bacteremia: I. Etiology and ecology. Arch Intern Med 110(6):847–855

    Article  Google Scholar 

  14. American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference (1992) Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med 20(6):864–874

    Article  Google Scholar 

  15. Paterson DL, Ko WC, Von Gottberg A, Mohapatra S, Casellas JM, Goossens H et al (2004) International prospective study of Klebsiella pneumoniae bacteremia: implications of extended-spectrum beta-lactamase production in nosocomial Infections. Ann Intern Med 140(1):26–32

    Article  PubMed  Google Scholar 

  16. Friedman ND, Kaye KS, Stout JE, McGarry SA, Trivette SL, Briggs JP et al (2002) Health care-associated bloodstream infections in adults: a reason to change the accepted definition of community-acquired infections. Ann Intern Med 137(10):791–797

    Article  PubMed  Google Scholar 

  17. Campillo B, Richardet JP, Kheo T, Dupeyron C (2002) Nosocomial spontaneous bacterial peritonitis and bacteremia in cirrhotic patients: impact of isolate type on prognosis and characteristics of infection. Clin Infect Dis 35(1):1–10

    Article  PubMed  Google Scholar 

  18. Infante-Rivard C, Esnaola S, Villeneuve JP (1987) Clinical and statistical validity of conventional prognostic factors in predicting short-term survival among cirrhotics. Hepatology 7(4):660–664

    Article  PubMed  CAS  Google Scholar 

  19. Kang CI, Song JH, Chung DR, Peck KR, Yeom JS, Ki HK et al (2011) Liver cirrhosis as a risk factor for mortality in a national cohort of patients with bacteremia. J Infect 63(5):336–343

    Article  PubMed  Google Scholar 

  20. Chen SY, Tsai CL, Lin CH, Lee CC, Chiang WC, Wang JL et al (2009) Impact of liver cirrhosis on mortality in patients with community-acquired bacteremia. Diagn Microbiol Infect Dis 64(2):124–130

    Article  PubMed  Google Scholar 

  21. Graudal N, Hubeck B, Bonde J, Thomsen AC (1987) The prognostic significance of bacteremia in hepatic cirrhosis. Liver 7(3):138–141

    Article  PubMed  CAS  Google Scholar 

  22. Schuppan D, Afdhal NH (2008) Liver cirrhosis. Lancet 371(9615):838–851

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  23. Mackenzie I, Woodhouse J (2006) C-reactive protein concentrations during bacteraemia: a comparison between patients with and without liver dysfunction. Intensive Care Med 32(9):1344–1351

    Article  PubMed  CAS  Google Scholar 

  24. Edwards MS, Baker CJ (2005) Group B streptococcal infections in elderly adults. Clin Infect Dis 41(6):839–847

    Article  PubMed  Google Scholar 

  25. Larppanichpoonphol P, Watanakunakorn C (2001) Group B streptococcal bacteremia in nonpregnant adults at a community teaching hospital. South Med J 94(12):1206–1211

    Article  PubMed  CAS  Google Scholar 

  26. Schrag SJ, Zywicki S, Farley MM, Reingold AL, Harrison LH, Lefkowitz LB et al (2000) Group B streptococcal disease in the era of intrapartum antibiotic prophylaxis. N Engl J Med 342(1):15–20

    Article  PubMed  CAS  Google Scholar 

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All authors declare that they have no conflicts of interest.

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This work was supported by the Dongguk University Research Fund of 2012.

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Correspondence to Y. Park.

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Park, S.Y., Park, Y., Chung, JW. et al. Group B streptococcal bacteremia in non-pregnant adults: results from two Korean centers. Eur J Clin Microbiol Infect Dis 33, 1785–1790 (2014). https://doi.org/10.1007/s10096-014-2140-9

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  • DOI: https://doi.org/10.1007/s10096-014-2140-9

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