title: Streptococcus agalactiae in adults at Chiang Mai University Hospital: a retrospective study.
abstract: BACKGROUND
  Infection caused by Streptococcus agalactiae, a Group B streptococcus, is an emerging disease in non-pregnant adults. This study describes the epidemiological, clinical, and microbiological characteristics of S. agalactiae infection in adult patients in northern Thailand.
  
  
  METHODS
  A retrospective study was conducted between January 1, 2006 and December 31, 2009 at Chiang Mai University Hospital among patients aged ≥15 years, whose clinical specimens obtained from normally sterile sites grew S. agalactiae.
  
  
  RESULTS
  One-hundred and eighty-six patients and 197 specimens were identified during the 4-year period. Among 186 patients, 82 were documented as having invasive infection; 42 patients were male (51.2%) with the mean age of 48.5 ± 19.4 years (range 17, 83). Fifty-three patients (64.6%) had underlying medical conditions; 17 patients (20.7%), 10 (12.2%), 8 (9.7%) had diabetes, chronic renal diseases, and malignancy, respectively. Among 40 patients (48.8%) with bloodstream infection, no other site of infection was determined in 29 (35.4%) patients. In the remaining 11 patients, 5 patients (6.1%), 5 (6.1%), and 1 (1.2%) had meningitis, arthritis, and meningitis with arthritis, respectively. Forty-two patients (51.2%) presented with localized infection, i.e., subcutaneous abscess (19 patients, 23.2%), chorioamnionitis (10 patients, 12.2%), urinary tract infection (5 patients, 6.1%), arthritis (3 patients, 3.7%), meningitis (2 patients, 2.4%), and spontaneous bacterial peritonitis, uveitis, and tracheobronchitis (1 patient each, 1.2%). The overall mortality was 14.6% (12 patients).
  
  
  CONCLUSIONS
  S. agalactiae infection is a growing problem in non-pregnant patients, particularly in those with underlying medical conditions. Physicians should add S. agalactiae infection in the list of differential diagnoses in patients with meningitis and/or septicemia.
authors: Department of Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. rchaiwar@gmail.com
authors: Romanee
authors: R
authors: Chaiwarith
authors: Waree
authors: W
authors: Jullaket
authors: Manasanant
authors: M
authors: Bunchoo
authors: Nontakan
authors: N
authors: Nuntachit
authors: Thira
authors: T
authors: Sirisanthana
authors: Khuanchai
authors: K
authors: Supparatpinyo
references: Expert Rev Mol Med. 2008 Sep 22;10:e27
references: 18803886
references: Arch Intern Med. 1997 Jan 27;157(2):213-6
references: 9009979
references: Am J Med Technol. 1979 Mar;45(3):199-204
references: 371403
references: J Microbiol Immunol Infect. 2006 Jun;39(3):237-41
references: 16783455
references: Rev Argent Microbiol. 2002 Oct-Dec;34(4):226-9
references: 12600008
references: JAMA. 2008 May 7;299(17):2056-65
references: 18460666
references: Future Microbiol. 2009 Mar;4(2):201-21
references: 19257847
references: Int J Infect Dis. 2009 Nov;13(6):679-84
references: 19131262
references: Am J Infect Control. 2008 Jun;36(5):309-32
references: 18538699
references: J Mol Med (Berl). 2010 Apr;88(4):371-81
references: 19960175
references: J Microbiol Immunol Infect. 2006 Oct;39(5):396-401
references: 17066202
references: Med Sci Monit. 2006 Nov;12(11):CR447-51
references: 17072267
references: N Engl J Med. 1993 Jun 24;328(25):1807-11
references: 8502269
references: J Clin Microbiol. 2003 Sep;41(9):4445-7
references: 12958289
references: J Perinat Neonatal Nurs. 2008 Jul-Sep;22(3):230-7
references: 18708876
references: Infect Dis Clin North Am. 2001 Jun;15(2):407-21, viii
references: 11447703
references: J Med Assoc Thai. 2006 Apr;89(4):411-4
references: 16696382
references: Antimicrob Agents Chemother. 1998 Jun;42(6):1517-9
references: 9624508
references: Clin Infect Dis. 2005 Sep 15;41(6):839-47
references: 16107984