title: Clinical and microbiological characteristics of recurrent group B streptococcal infection among non-pregnant adults.
abstract: OBJECTIVE
  This study aimed to investigate the clinical and microbiological features of recurrent group B streptococcal (GBS) diseases among non-pregnant adults.
  
  
  METHODS
  All hospitalized non-pregnant adults who had culture-proven GBS infections between January 2008 and December 2010 were enrolled in this retrospective study. Bacterial isolates were examined for their serotypes, genotypes, and antimicrobial resistance.
  
  
  RESULTS
  The recurrence rate of GBS infection in Taiwan was found to be 9.3%. Of the 70 recurrent episodes in 32 patients, infections of the urinary tract (U) were diagnosed clinically in 55.7%, infections of the soft tissue (S) in 31.4%, and infections of the bloodstream (B) in 12.9%. The initial/recurrent episodes in 25 patients were mainly U/U (40.6%), followed by S/S (18.8%) and B/B (6.2%). The serotypes/serogroups identified were serotypes V (34.3%), Ib (22.9%), VI (17.1%), III (12.9%), IV (7.1%), and Ia (5.7%). Recurrent strains showed less resistance to erythromycin or clindamycin than non-recurrent strains. Six distinct genotypes were identified in 12 serotype VI isolates derived from seven patients; five of these isolate pairs had identical genotypes.
  
  
  CONCLUSIONS
  Recurrent GBS diseases were found to occur considerably more often than previously thought, mainly in adults with a high comorbid index. Relapse, not new acquisition, was found to be more common.
authors: Department of Pediatrics, Chang Gung Memorial Hospital, Chiayi, Taiwan; Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors: Ying-Hsiang
authors: YH
authors: Wang
authors: Department of Pediatrics, Chang Gung Memorial Hospital, Chiayi, Taiwan.
authors: Hung-Ming
authors: HM
authors: Chen
authors: Department of Pediatrics, Chang Gung Memorial Hospital, Chiayi, Taiwan.
authors: Yun-Hsuan
authors: YH
authors: Yang
authors: Department of Laboratory Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan.
authors: Tsung-Han
authors: TH
authors: Yang
authors: Institute of Molecular Medicine, National Cheng Kung University Medical College, Tainan, Taiwan.
authors: Ching-Hao
authors: CH
authors: Teng
authors: Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors: Chyi-Liang
authors: CL
authors: Chen
authors: Department of Microbiology and Immunology, National Chiayi University, 300 University Road, Chiayi 600, Taiwan. Electronic address: cschu@mail.ncyu.edu.tw.
authors: Chishih
authors: C
authors: Chu
authors: Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University College of Medicine, 12L, No. 5, Fu-Hsin Str., Kweishan 333, Taoyuan, Taiwan. Electronic address: chchiu@adm.cgmh.org.tw.
authors: Cheng-Hsun
authors: CH
authors: Chiu
mesh_terms: D000328:Adult; D000368:Aged; D024881:Drug Resistance, Bacterial; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D065288:Serogroup; D012703:Serotyping; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000382:microbiology*; D013292:Streptococcus agalactiae / Q000145:classification / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification; D013624:Taiwan
keywords: Antimicrobial resistance; Group B streptococci; Recurrent; Serotype