Annals of Clinical Microbiology, The official Journal of the Korean Society of Clinical Microbiology

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Clinical Characteristics of Streptococcus agalactiae Bacteremia in Adults Living in Jeju Island

Original article

Annals of Clinical Microbiology (Ann Clin Microbiol) 2014 March, Volume 17, Issue 1, pages 9-13.

https://doi.org/10.5145/ACM.2014.17.1.9

Clinical Characteristics of Streptococcus agalactiae Bacteremia in Adults Living in Jeju Island

Kyutaeg Lee1, Woo Jin Kim1, Dong Lyul Kim1, Hyun Mi Ko1, Seung Hee Baik2, Mi Na Kim2, Moo Sang Chong3
Departments of 1Laboratory Medicine, 2Infection, Cheju Halla General Hospital, 3Department of Clinical Pathology, Cheju Halla College, Jeju, Korea

Abstract

Background: Streptococcus agalactiae (Group B streptococcus, GBS) is known to be the leading cause of neonatal sepsis and meningitis in the United States and Europe. In addition, GBS infection has been increasingly noted in adults, particularly in those with underlying diseases, such as diabetes mellitus, malignancy and liver disease. A few studies reported that resistances to antibiotics, such as erythromycin, clindamycin, tetracycline are increasing. We report clinical and microbiological characteristics of GBS bacteremic patients in Jeju Island.

Methods: We retrospectively analyzed medical records, such as age, sex, underlying disease, mortality, skin defects, laboratory results and antibiotic resistances of GBS in hospitalized adult patients who were diagnosed with GBS bacteremia from 2008 to 2013 in Jeju Island.

Results: Twenty two adult patients were diagnosed as GBS bacteremia from 2008 to 2013. The mean age of GBS bacteremic patients was 66.2 years old. Of 22 bacteremic patients, fifteen patients (68%) were older than 60. Twenty patients (91%) of bacteremic patients had underlying diseases such as diabetes mellitus, malignancy and liver disease. Ten (45%) patients had skin defects which were on the lower extremities and buttock, fifteen (68%) patients had fever at the time of admission, twenty one (95%) patients were admitted via the emergency department. Two (9%) patients died. The mean white blood cell (WBC) count, percentile of neutrophil count, and C-reactive protein (CRP) levels were 11,488/μL, 84.3 %, 13.5 mg/dL respectively. All GBS isolates from bacteremia showed sensitivities to penicillin, ampicillin, and vancomycin, and showed resistances to erythromycin (25%), clindamycin (30%), and tetracycline (55%).

Conclusion: Bacteremia caused by GBS was prevalent in adult patients with underlying diseases. Most of the GBS bacteremic patients were emergency cases, with a high body temperature, WBC, CRP level, and neutrophil count. Half of them had skin defects, which are considered a source of GBS bacteremia. (Ann Clin Microbiol 2014;17:9-13)

Keywords

Bacteremia, Drug resistance, Group B streptococci, Streptococcus agalactiae