Invasive group B streptococcal infections in a tertiary care hospital between 1998 and 2007 in Japan.
OBJECTIVE
To clarify clinical and microbiological features of invasive group B Streptococcus (GBS) disease in Japan.


METHODS
This was a retrospective review for the period 1998-2007 of patients across all age groups in Nishi-Kobe Medical Center. Invasive GBS disease was defined as GBS isolation from a normally sterile site or skin/soft tissues.


RESULTS
Six infant and 52 adult cases of invasive infection were identified. Diagnosis was limited to bacteremia and meningitis in infants, but varied widely in adults with skin/soft tissue infections and bacteremia being common. The overall fatality rate was 16%. An approximately 2.8-fold increase was found in the incidence among adult patients from the first to the second 5-year period. The most frequent underlying condition was diabetes, with the majority (18/23) of such patients showing poor control (HbA1c >8.0%). Amputation at the knee, ankle, or toes was performed in six diabetic adults with skin/soft tissue infections. Of the strains serotyped, types Ib and III predominated. All 58 strains were susceptible to penicillin; 2% were resistant to erythromycin and 3% were resistant to clindamycin.


CONCLUSIONS
This is the first epidemiological report describing invasive GBS disease in Japan. A significant increase in adult patients was noted, and mortality and morbidity remain substantial.
Matsubara
Kousaku
K
Department of Pediatrics, Nishi-Kobe Medical Center, 5-7-1 Kojidai, Nishi-ku, Kobe 651-2273, Japan. kskmatsu@s4.dion.ne.jp
Yamamoto
Go
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D008297:Male; D016920:Meningitis, Bacterial / Q000453:epidemiology / Q000382:microbiology; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011247:Pregnancy; D012703:Serotyping; D017192:Skin Diseases, Bacterial / Q000453:epidemiology / Q000382:microbiology; D018461:Soft Tissue Infections / Q000453:epidemiology / Q000382:microbiology; D013290:Streptococcal Infections / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality; D013292:Streptococcus agalactiae / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification; D055815:Young Adult
D000900:Anti-Bacterial Agents