Risk factors for group B streptococcal disease in adults.
OBJECTIVE
To determine risk factors for community-acquired and nosocomial group B streptococcal disease in adults.


METHODS
Case-control study.


METHODS
3 metropolitan areas in the United States with an aggregate population of 6.6 million persons.


METHODS
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.
Jackson
L A
LA
Childhood and Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Hilsdon
R
R
Farley
M M
MM
Harrison
L H
LH
Reingold
A L
AL
Plikaytis
B D
BD
Wenger
J D
JD
Schuchat
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000382:microbiology; D016022:Case-Control Studies; D017714:Community-Acquired Infections / Q000209:etiology* / Q000401:mortality; D003428:Cross Infection / Q000209:etiology* / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012307:Risk Factors; D013290:Streptococcal Infections / Q000209:etiology* / Q000401:mortality; D013292:Streptococcus agalactiae / Q000302:isolation & purification; D013577:Syndrome; D014481:United States / Q000453:epidemiology