Risk Factors and Mortality Rates Associated With Invasive Group B <i>Streptococcus</i> Infections Among Patients in the US Veterans Health Administration

Jump, Robin L.P.; Wilson, Brigid; Baechle, Daniel; Briggs, Janet; Banks, Richard; Song, Sunah; Zappernick, Taissa; Pérez, Federico

doi:10.1001/jamanetworkopen.2019.18324

Cited by 28 publications

(29 citation statements)

References 25 publications

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“…Our results are similar to those reported in the literature as global in-hospital mortality for non-pregnant adults is estimated to range from 3 to 23.7% worldwide [1,2,16]. Other factors previously associated with mortality are cancer, septic shock, peritonitis, endocarditis, and meningitis [8,23].…”

Section: Discussionsupporting

confidence: 90%

Invasive group B Streptococcus among non-pregnant adults in Brussels-Capital Region, 2005–2019

Graux

Hites

Martiny

et al. 2020

Eur J Clin Microbiol Infect Dis

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To assess the incidence, clinical, microbiological features and outcome of invasive Streptococcus agalactiae (GBS) infections in non-pregnant adults in three tertiary hospitals of the Brussels-Capital Region. All bacterial cultures positive for GBS, from 2005 to 2019 from 3 hospitals of the Brussels-Capital Region, were extracted, and only cases of invasive diseases were included. Medical files were retrospectively retrieved for risk factors, clinical manifestations and outcome and also antibiotic-susceptibility testing and GBS serotypes. Incidence rates were calculated based on the hospitals catchment populations. A total of 337 cases of GBS-invasive infections were included. The incidence of invasive GBS for the 3 hospitals increased from 3.7 to 8.2 cases per 100.000 inhabitants between 2009 and 2018 (p = 0.04). The most frequently identified risk factors were diabetes (36.8%), obesity (35.0%), cancer (21.7%), renal disease (20.8%), and advanced age (≥ 65 years; 47.2%). Isolated bacteremia (22%), osteoarticular infection (21.4%), abscesses (13.9%), and skin and soft tissue infections (18.4%) were the most frequent manifestations. Intensive care unit admission was required in 21.7% and overall mortality was 9.4%. All strains remained susceptible to penicillin over the years. Up to 20% of strains were resistant to clindamycin. Serotypes Ia, Ib, II, III, IV, and V represented 96.8% of the available serotypes (60/62). As reported in several countries, invasive GBS disease in non-pregnant adults represents an increasing burden, particularly among diabetic, obese, and elderly patients. Almost all serotypes identified are included in the upcoming hexavalent GBS conjugate vaccine.

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Section: Discussionsupporting

confidence: 90%

Invasive group B Streptococcus among non-pregnant adults in Brussels-Capital Region, 2005–2019

Graux

Hites

Martiny

et al. 2020

Eur J Clin Microbiol Infect Dis

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“…There is a plethora of studies which attempted to characterize the adults most susceptible to invasive GBS infection. While obesity and diabetes are most common underlying conditions associated with substantially increased risk of infection and mortality [10][11][12] , the role of NAFLD with GBS invasive disease outcomes has not been investigated.…”

Section: Introductionmentioning

confidence: 99%

Non-Alcoholic Fatty Liver Disease is Associated with an Increased Mortality in Adult Patients with Group B Streptococcus Invasive Disease

Gjurašin

Butić

Vince

et al. 2021

Infektol. glas. (Online)

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Background: Group B Streptococcus (GBS) is a significant cause of invasive disease among adult non-pregnant patients with increasing incidence and mortality rates. Although non-alcoholic fatty liver disease (NAFLD) is associated with components of metabolic syndrome previously recognized as risk factors for GBS, the impact of NAFLD on GBS course and outcomes is unknown. Methods: We conducted a retrospective cohort study of all non-pregnant adult patients diagnosed with invasive GBS infection during a 15-year period. Results: 102 patients were included in the study (46.1% males; median age 69, IQR 58-78 years). Disease primarily presented as bacteremia without a defined source (37; 36.3%), cellulitis/erysipelas (35; 34.3%), pneumonia (13; 12.7%) and endocarditis (8; 7.8%). The most common comorbidities were diabetes (42; 41.2%), dyslipidemia (39; 38.2%), cardiovascular disease (34; 33.3%), peripheral vascular disease (21; 20.6%), obesity (21; 20.6%) and malignancy (10; 9.8%). Based upon the results of abdominal ultrasound, the patients were divided into two groups: the ones with steatosis (44; 43.1%) and the ones without steatosis (58; 56.9%). There were no significant differences in clinical presentations and comorbidities between groups. In-hospital mortality was 29.5% (13/44) in patients with NAFLD and 10.3% (6/58) in the control group (p=0.0200). Endocarditis (OR 6.69; 95%CI 1.045-44.46, p=0.0410), acute renal failure (OR 13.92; 95%CI 3.00-77.71, p=0.0013), qSOFA > 2 (OR 23.93; 95%CI 4.66-171.2) and NAFLD (OR 6.64; 95%CI 1.23-47.88, p=0.0258) were independently associated with in-hospital mortality. Conclusions: NAFLD is associated with higher mortality in patients suffering from invasive GBS disease which appears to be independent of other components of the metabolic syndrome, such as obesity and diabetes mellitus.

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“…Kremers et al pointed out that the incidence of diabetes associated with osteomyelitis increased in the US with a higher prevalence in males than in females [ 62 ]. A more recent study demonstrated that the incidence of osteomyelitis more than doubled between 2008 and 2017 [ 63 ]. These results may explain the increased mortality rate with time in the present study.…”

Section: Discussionmentioning

confidence: 99%

The Characteristics and Mortality of Osteoporosis, Osteomyelitis, or Rheumatoid Arthritis in the Diabetes Population: A Retrospective Study

Huang

Zheng

et al. 2020

International Journal of Endocrinology

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Background. Patients with diabetes mellitus are prone to develop osteoporosis, osteomyelitis, or rheumatoid arthritis (RA). Furthermore, the presence of these complications in those with diabetes may lead to higher mortality. The aim of our study was to assess characteristics and mortality of osteoporosis, osteomyelitis, or rheumatoid arthritis in individuals with diabetes. Methods. We analyzed osteoporosis, osteomyelitis, and RA deaths associated with diabetes from 1999–2017 using the CDC WONDER system (CDC WONDER; https://wonder.cdc.gov). We used ICD-10 codes to categorize the underlying and contributing causes of death. Crude mortality rates (CMR) and age-adjusted mortality rates (AAMR) per 1,000,000 person-years were calculated. Results. The AAMR for osteoporosis in the population with diabetes was significantly higher in females (AAMR: 4.17, 95% CI: 4.10–4.24) than in males (AAMR: 1.12, 95% CI: 1.07–1.16). Deaths due to osteoporosis increased gradually from 1999, peaked in 2003 (AAMR: 3.78, 95% CI: 3.55–4.00), and reached a nadir in 2016 (AAMR: 2.32, 95% CI: 2.15–2.48). The AAMR for RA associated with diabetes was slightly higher in females (AAMR: 4.04, 95% CI: 3.98–4.11) than in males (AAMR: 2.45, 95% CI: 2.39–2.51). The mortality rate due to RA increased slightly from 1999 (AAMR: 3.18, 95% CI: 2.97–3.39) to 2017 (AAMR: 3.20, 95% CI: 3.02–3.38). The AAMR for osteomyelitis associated with diabetes was higher in males (AAMR: 4.36, 95% CI: 4.28–4.44) than in females (AAMR: 2.31, 95% CI: 2.26–2.36). From 1999 to 2017, the AAMR from osteomyelitis in this population was 2.63 (95% CI: 2.44–2.82) per 1,000,000 person-years in 1999 and 4.25 (95% CI: 4.05–4.46) per 1,000,000 person-years in 2017. Conclusions. We found an increase in the age-adjusted mortality rates of RA and osteomyelitis and a decrease of osteoporosis associated with diabetes from 1999 to 2017. We suggest that increased attention should therefore be given to these diseases in the population with diabetes, especially in efforts to develop preventative and treatment strategies.

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Risk Factors and Mortality Rates Associated With Invasive Group B Streptococcus Infections Among Patients in the US Veterans Health Administration

Cited by 28 publications

References 25 publications

Invasive group B Streptococcus among non-pregnant adults in Brussels-Capital Region, 2005–2019

Invasive group B Streptococcus among non-pregnant adults in Brussels-Capital Region, 2005–2019

Non-Alcoholic Fatty Liver Disease is Associated with an Increased Mortality in Adult Patients with Group B Streptococcus Invasive Disease

The Characteristics and Mortality of Osteoporosis, Osteomyelitis, or Rheumatoid Arthritis in the Diabetes Population: A Retrospective Study

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