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Streptococcus agalactiae bone and joint infection: a multicentre observational study 2014-23
Simon Jamard1, Mathilde Jan2, Gwenael LE Moal3
1Service de Maladies Infectieuses et Tropicales, Hôpital Bretonneau, CHRU de Tours, 37044 Tours, France; Université de Tours, INRAe UMR1282, Infectiologie et Santé Publique, BRMF, Tours, France; ESCMID Study Group for Biofilm, ESGB, Switzerland.
The Journal of Infection
|July 7, 2026
Summary
Streptococcus agalactiae is a key cause of bone and joint infections (BJIs), distinct from other streptococci. Arteriopathy and obesity are identified as specific risk factors for these chronic S. agalactiae BJIs.
Area of Science:
- Infectious Diseases
- Microbiology
- Epidemiology
Background:
- Streptococcus is the second most common bacterial genus causing bone and joint infections (BJIs).
- Streptococcus agalactiae is the predominant Streptococcus species implicated in BJIs, yet epidemiological data is scarce.
- This study aimed to delineate the distinct features of S. agalactiae BJIs compared to other streptococcal BJIs.
Purpose of the Study:
- To describe the epidemiological and clinical characteristics of Streptococcus agalactiae BJIs.
- To identify specific risk factors associated with S. agalactiae BJIs.
- To compare S. agalactiae BJIs with those caused by other Streptococcus species.
Main Methods:
- A multicentre retrospective observational study of adult patients with microbiologically confirmed streptococcal BJIs (2014-2023).
- Comparison of S. agalactiae BJIs with other streptococcal BJIs to identify risk factors.
- Characterization of 143 S. agalactiae strains using CRISPR1 typing.
Main Results:
- Streptococcus agalactiae accounted for 29% of streptococcal BJIs (423/1454 patients).
- Obesity and diabetes mellitus were the most prevalent comorbidities.
- S. agalactiae BJIs were significantly associated with diabetic foot osteitis, lower-limb infections, and chronic infections.
- Arteriopathy (OR: 4.16) and obesity (OR: 2.57) were identified as specific risk factors.
- Three main clonal complexes (CC1, CC23, CC10) were identified in S. agalactiae BJI strains.
Conclusions:
- Streptococcus agalactiae is a prominent and distinct pathogen in complex BJIs.
- Specific risk factors for S. agalactiae BJIs include arteriopathy and obesity.
- S. agalactiae BJIs tend to be more chronic compared to other streptococcal BJIs.
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