Community-acquired group B streptococcal meningitis in adults
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Updated: Jan 2, 2026
A Murine Model of Group B Streptococcus Vaginal Colonization
Published on: November 16, 2016
Merel N van Kassel1, Koen J van Haeringen1, Matthijs C Brouwer1
1Department of Neurology, Amsterdam Neuroscience, University of Amsterdam, Amsterdam University Medical Centers, Meibergdreef 9, the Netherlands.
Introduction:
Streptococcus agalactiae (group B streptococci; GBS) is an uncommon cause of bacterial meningitis in adults.
Methods:
We reviewed literature published between 1975 and 2018. Studies were included if they reported age, sex and outcome of patients above 16 years of age with cerebrospinal fluid culture (CSF) positive for GBS.
Results:
Sixty-seven articles describing 141 patients were included. Median age was 56 years (IQR 41-66); 52% were male. Fifty-three patients (38%) were immunocompromised and CSF leakage was reported in 9 (10%) of 88 immunocompetent patients. Sixty-two patients (44%) had extra-meningeal foci of infection, most commonly endocarditis, which occurred in 14 patients (12%). Twenty-eight patients (23%) were described as previously healthy. Forty-four (31%) of the 141 patients died, after a median duration of 5 days after admission. Death was associated with advanced age and an immunocompromised state.
Conclusion:
GBS meningitis in adults mainly occurs in those with underlying conditions such as immunocompromised state, CSF leakage, and endocarditis. These conditions should be actively sought for in adults with GBS meningitis.
Insights
Group B Streptococcus (GBS) meningitis is rare in adults, often linked to underlying conditions. Early identification of these factors is crucial for managing GBS meningitis in adults.
Area of Science:
- Infectious Diseases
- Neurology
- Microbiology
Background:
- Streptococcus agalactiae, or group B Streptococcus (GBS), is an infrequent cause of bacterial meningitis in adult populations.
- Adult GBS meningitis is often associated with specific underlying health conditions.
Purpose of the Study:
- To review and synthesize existing literature on adult GBS meningitis.
- To identify key patient demographics, associated conditions, and outcomes.
Main Methods:
- A comprehensive literature review was conducted for studies published between 1975 and 2018.
- Inclusion criteria required studies to report age, sex, and outcomes for patients over 16 with GBS-positive cerebrospinal fluid cultures.
Main Results:
- The review included 67 articles detailing 141 adult patients with GBS meningitis (median age 56 years; 52% male).
- Significant findings included a high prevalence of immunocompromised patients (38%), extra-meningeal infection foci (44%, notably endocarditis in 12%), and a mortality rate of 31%.
- Death was correlated with advanced age and immunocompromised status.
Conclusions:
- Adult GBS meningitis predominantly affects individuals with pre-existing conditions like immunocompromise, CSF leakage, and endocarditis.
- Healthcare providers should proactively screen for these underlying conditions in adult patients diagnosed with GBS meningitis.
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