Increasing Burden of Invasive Group B Streptococcal Disease in Nonpregnant Adults, 1990–2007
Identifieur interne : 000877 ( Main/Exploration ); précédent : 000876; suivant : 000878Increasing Burden of Invasive Group B Streptococcal Disease in Nonpregnant Adults, 1990–2007
Auteurs : Tami H. Skoff ; Monica M. Farley ; Susan Petit ; Allen S. Craig ; William Schaffner ; Ken Gershman ; Lee H. Harrison ; Ruth Lynfield ; Janet Mohle-Boetani ; Shelley Zansky ; Bernadette A. Albanese ; Karen Stefonek ; Elizabeth R. Zell ; Delois Jackson ; Terry Thompson ; Stephanie J. SchragSource :
- Clinical Infectious Diseases [ 1058-4838 ] ; 2009-07-01.
Abstract
Background. Group B Streptococcus (GBS), traditionally considered to be a neonatal pathogen, is an important cause of morbidity and mortality among older adults and among those with underlying medical conditions. We used population-based surveillance to examine trends in adult GBS disease during the period 1990–2007 and to describe the epidemiology of adult GBS disease to guide prevention efforts. Methods. Active Bacterial Core surveillance was conducted in selected counties in 10 US states. A case was defined as isolation of GBS from a normally sterile site in a nonpregnant resident of a surveillance area who was ⩾18 years of age. Rates were calculated using US Census data. Demographic and clinical information was abstracted from medical records. Serotyping and susceptibility testing were performed on isolates collected from a subset of case patients. Results. A total of 19,512 GBS cases were identified in nonpregnant adults during 1990–2007 (median patient age, 63 years); the incidence of adult GBS disease doubled from 3.6 cases per 100,000 persons during 1990 to 7.3 cases per 100,000 persons during 2007 (P<.001). The mean difference in incidence between black and white persons was 4.6 cases per 100,000 persons (range, 3.1 cases per 100,000 persons during 1991 to 5.8 cases per 100,000 persons during 1999). Common clinical syndromes in 2007 included bacteremia without focus (39.3%), skin and/or soft-tissue infection (25.6%), and pneumonia (12.6%). Most (88.0%) GBS cases in adults had ⩾1 underlying condition; diabetes was present in 44.4% of cases. Serotypes V, Ia, II, and III accounted for 80.8% of infections during 1998–1999 and 78.5% of infections during 2005–2006. Conclusions. Invasive GBS disease in nonpregnant adults represents a substantial and increasing burden, particularly among older persons, black persons, and adults with diabetes. Prevention strategies are needed.
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DOI: 10.1086/599369
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Craig</name></author><author><name sortKey="Schaffner, William" sort="Schaffner, William" uniqKey="Schaffner W" first="William" last="Schaffner">William Schaffner</name></author><author><name sortKey="Gershman, Ken" sort="Gershman, Ken" uniqKey="Gershman K" first="Ken" last="Gershman">Ken Gershman</name></author><author><name sortKey="Harrison, Lee H" sort="Harrison, Lee H" uniqKey="Harrison L" first="Lee H." last="Harrison">Lee H. Harrison</name></author><author><name sortKey="Lynfield, Ruth" sort="Lynfield, Ruth" uniqKey="Lynfield R" first="Ruth" last="Lynfield">Ruth Lynfield</name></author><author><name sortKey="Mohle Boetani, Janet" sort="Mohle Boetani, Janet" uniqKey="Mohle Boetani J" first="Janet" last="Mohle-Boetani">Janet Mohle-Boetani</name></author><author><name sortKey="Zansky, Shelley" sort="Zansky, Shelley" uniqKey="Zansky S" first="Shelley" last="Zansky">Shelley Zansky</name></author><author><name sortKey="Albanese, Bernadette A" sort="Albanese, Bernadette A" uniqKey="Albanese B" first="Bernadette A." last="Albanese">Bernadette A. Albanese</name></author><author><name sortKey="Stefonek, Karen" sort="Stefonek, Karen" uniqKey="Stefonek K" first="Karen" last="Stefonek">Karen Stefonek</name></author><author><name sortKey="Zell, Elizabeth R" sort="Zell, Elizabeth R" uniqKey="Zell E" first="Elizabeth R." last="Zell">Elizabeth R. 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Skoff</name><affiliation><wicri:noCountry code="syntax">???</wicri:noCountry></affiliation><affiliation><wicri:noCountry code="no comma">E-mail: tlh9@cdc.gov</wicri:noCountry></affiliation></author><author><name sortKey="Farley, Monica M" sort="Farley, Monica M" uniqKey="Farley M" first="Monica M." last="Farley">Monica M. Farley</name><affiliation><wicri:noCountry code="syntax">???</wicri:noCountry></affiliation><affiliation><wicri:noCountry code="syntax">???</wicri:noCountry></affiliation></author><author><name sortKey="Petit, Susan" sort="Petit, Susan" uniqKey="Petit S" first="Susan" last="Petit">Susan Petit</name><affiliation><wicri:noCountry code="syntax">???</wicri:noCountry></affiliation></author><author><name sortKey="Craig, Allen S" sort="Craig, Allen S" uniqKey="Craig A" first="Allen S." last="Craig">Allen S. Craig</name><affiliation><wicri:noCountry code="syntax">???</wicri:noCountry></affiliation></author><author><name sortKey="Schaffner, William" sort="Schaffner, William" uniqKey="Schaffner W" first="William" last="Schaffner">William Schaffner</name><affiliation><wicri:noCountry code="syntax">???</wicri:noCountry></affiliation></author><author><name sortKey="Gershman, Ken" sort="Gershman, Ken" uniqKey="Gershman K" first="Ken" last="Gershman">Ken Gershman</name><affiliation><wicri:noCountry code="syntax">???</wicri:noCountry></affiliation></author><author><name sortKey="Harrison, Lee H" sort="Harrison, Lee H" uniqKey="Harrison L" first="Lee H." last="Harrison">Lee H. 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Schrag</name><affiliation><wicri:noCountry code="syntax">???</wicri:noCountry></affiliation></author></analytic><monogr></monogr><series><title level="j">Clinical Infectious Diseases</title><title level="j" type="abbrev">Clinical Infectious Diseases</title><idno type="ISSN">1058-4838</idno><idno type="eISSN">1537-6591</idno><imprint><publisher>The University of Chicago Press</publisher><date type="published" when="2009-07-01">2009-07-01</date><biblScope unit="volume">49</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="85">85</biblScope><biblScope unit="page" to="92">92</biblScope></imprint><idno type="ISSN">1058-4838</idno></series><idno type="istex">B5FD9C7EF2536F67362C4D5CB8D1ED115D08BABE</idno><idno type="DOI">10.1086/599369</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1058-4838</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Background. Group B Streptococcus (GBS), traditionally considered to be a neonatal pathogen, is an important cause of morbidity and mortality among older adults and among those with underlying medical conditions. We used population-based surveillance to examine trends in adult GBS disease during the period 1990–2007 and to describe the epidemiology of adult GBS disease to guide prevention efforts. Methods. Active Bacterial Core surveillance was conducted in selected counties in 10 US states. A case was defined as isolation of GBS from a normally sterile site in a nonpregnant resident of a surveillance area who was ⩾18 years of age. Rates were calculated using US Census data. Demographic and clinical information was abstracted from medical records. Serotyping and susceptibility testing were performed on isolates collected from a subset of case patients. Results. A total of 19,512 GBS cases were identified in nonpregnant adults during 1990–2007 (median patient age, 63 years); the incidence of adult GBS disease doubled from 3.6 cases per 100,000 persons during 1990 to 7.3 cases per 100,000 persons during 2007 (P<.001). The mean difference in incidence between black and white persons was 4.6 cases per 100,000 persons (range, 3.1 cases per 100,000 persons during 1991 to 5.8 cases per 100,000 persons during 1999). Common clinical syndromes in 2007 included bacteremia without focus (39.3%), skin and/or soft-tissue infection (25.6%), and pneumonia (12.6%). Most (88.0%) GBS cases in adults had ⩾1 underlying condition; diabetes was present in 44.4% of cases. Serotypes V, Ia, II, and III accounted for 80.8% of infections during 1998–1999 and 78.5% of infections during 2005–2006. Conclusions. Invasive GBS disease in nonpregnant adults represents a substantial and increasing burden, particularly among older persons, black persons, and adults with diabetes. Prevention strategies are needed.</div></front></TEI><affiliations><list></list><tree><noCountry><name sortKey="Albanese, Bernadette A" sort="Albanese, Bernadette A" uniqKey="Albanese B" first="Bernadette A." last="Albanese">Bernadette A. Albanese</name><name sortKey="Craig, Allen S" sort="Craig, Allen S" uniqKey="Craig A" first="Allen S." last="Craig">Allen S. Craig</name><name sortKey="Farley, Monica M" sort="Farley, Monica M" uniqKey="Farley M" first="Monica M." last="Farley">Monica M. Farley</name><name sortKey="Gershman, Ken" sort="Gershman, Ken" uniqKey="Gershman K" first="Ken" last="Gershman">Ken Gershman</name><name sortKey="Harrison, Lee H" sort="Harrison, Lee H" uniqKey="Harrison L" first="Lee H." last="Harrison">Lee H. Harrison</name><name sortKey="Jackson, Delois" sort="Jackson, Delois" uniqKey="Jackson D" first="Delois" last="Jackson">Delois Jackson</name><name sortKey="Lynfield, Ruth" sort="Lynfield, Ruth" uniqKey="Lynfield R" first="Ruth" last="Lynfield">Ruth Lynfield</name><name sortKey="Mohle Boetani, Janet" sort="Mohle Boetani, Janet" uniqKey="Mohle Boetani J" first="Janet" last="Mohle-Boetani">Janet Mohle-Boetani</name><name sortKey="Petit, Susan" sort="Petit, Susan" uniqKey="Petit S" first="Susan" last="Petit">Susan Petit</name><name sortKey="Schaffner, William" sort="Schaffner, William" uniqKey="Schaffner W" first="William" last="Schaffner">William Schaffner</name><name sortKey="Schrag, Stephanie J" sort="Schrag, Stephanie J" uniqKey="Schrag S" first="Stephanie J." last="Schrag">Stephanie J. Schrag</name><name sortKey="Skoff, Tami H" sort="Skoff, Tami H" uniqKey="Skoff T" first="Tami H." last="Skoff">Tami H. Skoff</name><name sortKey="Stefonek, Karen" sort="Stefonek, Karen" uniqKey="Stefonek K" first="Karen" last="Stefonek">Karen Stefonek</name><name sortKey="Thompson, Terry" sort="Thompson, Terry" uniqKey="Thompson T" first="Terry" last="Thompson">Terry Thompson</name><name sortKey="Zansky, Shelley" sort="Zansky, Shelley" uniqKey="Zansky S" first="Shelley" last="Zansky">Shelley Zansky</name><name sortKey="Zell, Elizabeth R" sort="Zell, Elizabeth R" uniqKey="Zell E" first="Elizabeth R." last="Zell">Elizabeth R. Zell</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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