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Relapsing invasive group B streptococcal infection in adults
L H Harrison1, A Ali, D M Dwyer
1Department of International Health, Johns Hopkins University, Baltimore, MD 21205, USA.
Annals of Internal Medicine
|September 15, 1995
Summary
Recurrent group B streptococcal infections are common in adults, often caused by the same bacterial strain relapsing. Further research is needed to determine optimal management for first-time infections to prevent recurrence.
Area of Science:
- Infectious Diseases
- Bacteriology
- Clinical Microbiology
Background:
- Group B Streptococcus (GBS) is a significant pathogen, primarily known for neonatal infections but also causing invasive disease in adults.
- Recurrent GBS infections in adults are not well-characterized, necessitating investigation into their incidence and causative factors.
Purpose of the Study:
- To investigate the occurrence and characteristics of recurrent group B streptococcal infections in adult populations.
- To determine if recurrent GBS infections are caused by the same or different strains of the bacteria.
Main Methods:
- Active surveillance was employed to identify adult patients with multiple GBS infections.
- Sterile-site GBS isolates underwent serotyping and molecular subtyping using restriction endonuclease analysis of chromosomal DNA (REAC).
Main Results:
- Of 395 patients with invasive GBS infection, 17 (4.3%) experienced more than one episode.
- In 13 of 18 pairs of isolates from recurrent infections, identical REAC patterns indicated the same bacterial strain was responsible (P < 0.000001).
- Recurrence caused by the same strain had a shorter interval (mean, 14 weeks) than recurrence by a different strain (mean, 43 weeks).
Conclusions:
- Recurrent group B streptococcal infections are relatively common in adults.
- Most recurrent cases appear to result from relapse of the initial infection, caused by the same bacterial strain.
- Optimal strategies for managing initial GBS infections in adults require further definition to reduce the risk of subsequent episodes.
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