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Streptococcus agalactiae infection in cancer patients: a five-year study

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Abstract

Although the highest burden of Streptococcus agalactiae infections has been reported in industrialized countries, studies on the characterization and epidemiology are still limited in developing countries and implementation of control strategies remains undefined. The aim of this retrospective study was to assess the epidemiological, clinical, and microbiological aspects of S. agalactiae infections in cancer patients treated at a Reference Brazilian National Cancer Institute - INCA, Rio de Janeiro, Brazil. We reviewed the clinical and laboratory records of all cancer patients identified as having invasive S. agalactiae disease during 2010–2014. The isolates were identified by biochemical analysis and tested for antimicrobial susceptibility. A total of 263 strains of S. agalactiae were isolated from cancer patients who had been clinically and microbiologically classified as infected. S. agalactiae infections were mostly detected among adults with solid tumors (94 %) and/or patients who have used indwelling medical devices (77.2 %) or submitted to surgical procedures (71.5 %). Mortality rates (in-hospital mortality during 30 days after the identification of S. agalactiae) related to invasive S. agalactiae infections (n = 28; 31.1 %) for the specific category of neoplasic diseases were: gastrointestinal (46 %), head and neck (25 %), lung (11 %), hematologic (11 %), gynecologic (4 %), and genitourinary (3 %). We also found an increase in S. agalactiae resistance to erythromycin and clindamycin and the emergence of penicillin-less susceptible isolates. A remarkable number of cases of invasive infections due to S. agalactiae strains was identified, mostly in adult patients. Our findings reinforce the need for S. agalactiae control measures in Brazil, including cancer patients.

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References

  1. Oster G, Edelsberg J, Hennegan K, Lewin C, Narasimhan V, Slobod K, Edwards MS, Baker CJ (2014) Prevention of group B streptococcal disease in the first 3 months of life: would routine maternal immunization during pregnancy be cost-effective? Vaccine 32:4778–4785

    Article  PubMed  Google Scholar 

  2. Tazi A, Morand PC, Réglier-Poupet H, Dmytruk N, Billoët A, Antona D, Trieu-Cuot P, Poyart C (2011) Invasive group B streptococcal infections in adults, France (2007–2010). Clin Microbiol Infect 17:1587–1589

    Article  CAS  PubMed  Google Scholar 

  3. Verani JR, McGee L, Schrag SJ; Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC) (2010) Prevention of perinatal group B streptococcal disease—revised guidelines from CDC, 2010. MMWR Recomm Rep 59(RR-10):1–36

    PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  5. Kimura K, Nagano N, Nagano Y, Suzuki S, Wachino J, Shibayama K, Arakawa Y (2013) High frequency of fluoroquinolone- and macrolide-resistant streptococci among clinically isolated group B streptococci with reduced penicillin susceptibility. J Antimicrob Chemother 68:539–542

    Article  CAS  PubMed  Google Scholar 

  6. Edmond KM, Kortsalioudaki C, Scott S, Schrag SJ, Zaidi AKM, Cousens S, Heath PT (2012) Group B streptococcal disease in infants aged younger than 3 months: systematic review and meta-analysis. Lancet 379:547–556

    Article  PubMed  Google Scholar 

  7. Johri AK, Lata H, Yadav P, Dua M, Yang Y, Xu X, Homma A, Barocchi MA, Bottomley MJ, Saul A, Klugman KP, Black S (2013) Epidemiology of Group B Streptococcus in developing countries. Vaccine 31(Suppl 4):D43–D45

    Article  PubMed  Google Scholar 

  8. Crespo-Ortiz MP, Castañeda-Ramirez CR, Recalde-Bolaños M, Vélez-Londoño JD (2014) Emerging trends in invasive and noninvasive isolates of Streptococcus agalactiae in a Latin American hospital: a 17-year study. BMC Infect Dis 14:428–439

    Article  PubMed Central  Google Scholar 

  9. Hughes WT, Flynn PM, Williams BG (1996) Nosocomial infection in patients with neoplastic diseases. In: Mayall CG (ed) Hospital epidemiology and infection control, 1st edn. Williams and Wilkins, Maryland, pp 618–631

    Google Scholar 

  10. Spellerberg B, Brandt C (2015) Streptococcus. In: Jorgensen JH, Pfaller MA, Carroll KC, Funke G, Landry ML, Richter SS, Warnock DW (eds) Manual of clinical microbiology, 11th edn. ASM Press, Washington, pp 383–402

    Chapter  Google Scholar 

  11. Clinical and Laboratory Standards Institute (CLSI) (2015) Performance standards for antimicrobial susceptibility testing; Twenty-fifth informational supplement. CLSI document M100-S25. CLSI, Wayne

    Google Scholar 

  12. Blancas D, Santin M, Olmo M, Alcaide F, Carratala J, Gudiol F (2004) Group B streptococcal disease in nonpregnant adults: incidence, clinical characteristics, and outcome. Eur J Clin Microbiol Infect Dis 23:168–173

    Article  CAS  PubMed  Google Scholar 

  13. Skoff TH, Farley MM, Petit S, Craig AS, Schaffner W, Gershman K, Harrison LH, Lynfield R, Mohle-Boetani J, Zansky S, Albanese BA, Stefonek K, Zell ER, Jackson D, Thompson T, Schrag SJ (2009) Increasing burden of invasive group B streptococcal disease in nonpregnant adults, 1990–2007. Clin Infect Dis 49:85–92

    Article  PubMed  Google Scholar 

  14. Sendi P, Johansson L, Norrby-Teglund A (2008) Invasive group B Streptococcal disease in non-pregnant adults: a review with emphasis on skin and soft-tissue infections. Infection 36:100–111

    Article  CAS  PubMed  Google Scholar 

  15. Dagnew AF, Cunnington MC, Dube Q, Edwards MS, French N, Heyderman RS, Madhi SA, Slobod K, Clemens SA (2012) Variation in reported neonatal group B streptococcal disease incidence in developing countries. Clin Infect Dis 55:91–102

    Article  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  17. Ho CM, Chi CY, Ho MW, Chen CM, Liao WC, Liu YM, Lin PC, Wang JH (2006) Clinical characteristics of group B Streptococcus bacteremia in non-pregnant adults. J Microbiol Immunol Infect 39:396–401

    PubMed  Google Scholar 

  18. Chaiwarith R, Jullaket W, Bunchoo M, Nuntachit N, Sirisanthana T, Supparatpinyo K (2011) Streptococcus agalactiae in adults at Chiang Mai University Hospital: a retrospective study. BMC Infect Dis 11:149–156

    Article  PubMed  PubMed Central  Google Scholar 

  19. Tan CK, Ulett KB, Steele M, Benjamin WH, Ulett GC (2012) Prognostic value of semi-quantitative bacteruria counts in the diagnosis of group B Streptococcus urinary tract infection: a 4-year retrospective study in adult patients. BMC Infect Dis 12:273–282

    Article  PubMed  PubMed Central  Google Scholar 

  20. Nagano N, Nagano Y, Toyama M, Kimura K, Shibayama K, Arakawa Y (2014) Penicillin-susceptible group B streptococcal clinical isolates with reduced cephalosporin susceptibility. J Clin Microbiol 52:3406–3410

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Kimura K, Nagano N, Arakawa Y (2015) Classification of group B streptococci with reduced β-lactam susceptibility (GBS-RBS) based on the amino acid substitutions in PBPs. J Antimicrob Chemother 70:1601–1603

    CAS  PubMed  Google Scholar 

  22. Longtin J, Vermeiren C, Shahinas D, Tamber GS, McGeer A, Low DE, Katz K, Pillai DR (2011) Novel mutations in a patient isolate of Streptococcus agalactiae with reduced penicillin susceptibility emerging after long-term oral suppressive therapy. Antimicrob Agents Chemother 55:2983–2985

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

Funding support for this project was provided by CNPq, FAPERJ, and SR2-UERJ.

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Authors and Affiliations

  1. Roberto Alcântara Biology Institute, Rio de Janeiro State University - UERJ, Rio de Janeiro, RJ–LBMFE/IBRAG, Rua São Francisco Xavier, 524 - PHLC 5º andar sala 501B- Maracanã, 20550-013, Rio de Janeiro, RJ, Brazil

    B. A. S. Pimentel, J. C. Mendonça, P. S. D. Miranda, G. F. Sanches & P. E. Nagao

  2. National Cancer Institute - INCA, Rio de Janeiro, RJ–HICC/HC1, Rio de Janeiro, Brazil

    C. A. S. Martins

  3. Faculty of Medical Sciences, Rio de Janeiro State University - UERJ, Rio de Janeiro, RJ–LDCIC/FCM, Rio de Janeiro, Brazil

    A. L. Mattos-Guaraldi

Authors
  1. B. A. S. Pimentel
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  2. C. A. S. Martins
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  3. J. C. Mendonça
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  4. P. S. D. Miranda
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  5. G. F. Sanches
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  6. A. L. Mattos-Guaraldi
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  7. P. E. Nagao
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Corresponding author

Correspondence to P. E. Nagao.

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All authors participated in the design of the study, review and interpretation of the data, and the drafting of this manuscript. All procedures followed were in accordance with the Institutional Ethic Commission, Instituto Nacional do Cancer (INCA)/Rio de Janeiro Pedro Ernesto Hospital University.

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None declared.

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Pimentel, B.A.S., Martins, C.A.S., Mendonça, J.C. et al. Streptococcus agalactiae infection in cancer patients: a five-year study. Eur J Clin Microbiol Infect Dis 35, 927–933 (2016). https://doi.org/10.1007/s10096-016-2617-9

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  • DOI: https://doi.org/10.1007/s10096-016-2617-9

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