Group B streptococcal bacteremia in a major teaching hospital in Malaysia

A case series of eighteen patients

N. Eskandarian, V. Neela, Zalina Ismail, S. M. Puzi, R. A. Hamat, M. N M Desa, S. A. Nordin

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: Group B Streptococcus (GBS) is a leading cause of infections such as meningitis and septicemia in neonates and pregnant women; however the significance of invasive GBS disease has not been clearly defined in non-pregnant adults. Methods: We reviewed the hospital records of 18 cases with GBS bacteremia who attended the Universiti Kebangsaan Malaysia Medical Centre from June 2010 to October 2011. We analyzed the clinical findings of both bacteremic adults and neonates and compared them to previous studies of GBS bacteremia. Serotyping was done by latex agglutination test using 10 distinct antisera (Ia, Ib, and II-IX). Results: During the period of 1 year and 4 months, there were 18 patients with GBS bacteremia. Five cases occurred in neonates, one in a parturient woman, and 12 in other adults. All neonates with bacteremia were males and two of them were premature. Septicemia was the most common clinical presentation in neonates. They were treated with intravenous (IV) penicillin G and gentamicin. The adults included nine men (69%) and four women (31%). Their mean age was 60 years and all patients had more than two underlying conditions. The most common clinical syndrome was pneumonia (n=6, 46.5%). The others were peritonitis (n=3, 23.1%), primary bacteremia (n=2, 15.5%), septic arthritis (n=2, 15.5%), skin and soft tissue infection (n=1, 7.7%), meningitis (n=1, 8%), urinary tract infection (n=1, 8%), and intravascular device infection (n=1, 7.7%). Cardiovascular diseases (n=7, 53.8%) were the most common underlying conditions, and diabetes mellitus (n=5, 38.5%) was second. The other co-morbid conditions were hyperlipidemia (n=3, 23.1%), renal disease (n=3, 23.1%), liver disease and/or alcohol abuse (n=3, 23.1%), autoimmune disease or immunosuppressive condition (n=2, 15.5%), malignancy (n=2, 15.5%), respiratory disease (n=1, 8%), and postpartum condition (n=1, 8%), as well as miscellaneous conditions including intravenous drug abuse, HIV infection, and trauma (n=2, 15.5%). Polymicrobial bacteremia was found in five (45.4%) cases and Staphylococcus aureus was the most common concurrent bacterial isolate. Of the 18 GBS isolates in both adults and neonates, serotype Ia was predominant (38.9%), followed by VI (27.8%), V (11.1%), and III (5.5%); the remaining 16.7% were non-typeable. Conclusions: GBS bacteremia is a significant problem and is associated with serious underlying disease, which may result in a high rate of mortality, not only in neonates and pregnant women, but also in non-pregnant adults.

Original languageEnglish
JournalInternational Journal of Infectious Diseases
Volume17
Issue number9
DOIs
Publication statusPublished - Sep 2013

Fingerprint

Streptococcus agalactiae
Malaysia
Bacteremia
Teaching Hospitals
Newborn Infant
Meningitis
Pregnant Women
Sepsis
Intravenous Substance Abuse
Latex Fixation Tests
Serotyping
Infectious Arthritis
Soft Tissue Infections
Penicillin G
Hospital Records
Immunosuppressive Agents
Infection
Gentamicins
Hyperlipidemias
Peritonitis

Keywords

  • Adult
  • Bacteremia
  • GBS
  • Malaysia
  • Neonate

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Group B streptococcal bacteremia in a major teaching hospital in Malaysia : A case series of eighteen patients. / Eskandarian, N.; Neela, V.; Ismail, Zalina; Puzi, S. M.; Hamat, R. A.; Desa, M. N M; Nordin, S. A.

In: International Journal of Infectious Diseases, Vol. 17, No. 9, 09.2013.

Research output: Contribution to journalArticle

Eskandarian, N. ; Neela, V. ; Ismail, Zalina ; Puzi, S. M. ; Hamat, R. A. ; Desa, M. N M ; Nordin, S. A. / Group B streptococcal bacteremia in a major teaching hospital in Malaysia : A case series of eighteen patients. In: International Journal of Infectious Diseases. 2013 ; Vol. 17, No. 9.
@article{f4d017c5241045f3bfcd4403e85d00e5,
title = "Group B streptococcal bacteremia in a major teaching hospital in Malaysia: A case series of eighteen patients",
abstract = "Background: Group B Streptococcus (GBS) is a leading cause of infections such as meningitis and septicemia in neonates and pregnant women; however the significance of invasive GBS disease has not been clearly defined in non-pregnant adults. Methods: We reviewed the hospital records of 18 cases with GBS bacteremia who attended the Universiti Kebangsaan Malaysia Medical Centre from June 2010 to October 2011. We analyzed the clinical findings of both bacteremic adults and neonates and compared them to previous studies of GBS bacteremia. Serotyping was done by latex agglutination test using 10 distinct antisera (Ia, Ib, and II-IX). Results: During the period of 1 year and 4 months, there were 18 patients with GBS bacteremia. Five cases occurred in neonates, one in a parturient woman, and 12 in other adults. All neonates with bacteremia were males and two of them were premature. Septicemia was the most common clinical presentation in neonates. They were treated with intravenous (IV) penicillin G and gentamicin. The adults included nine men (69{\%}) and four women (31{\%}). Their mean age was 60 years and all patients had more than two underlying conditions. The most common clinical syndrome was pneumonia (n=6, 46.5{\%}). The others were peritonitis (n=3, 23.1{\%}), primary bacteremia (n=2, 15.5{\%}), septic arthritis (n=2, 15.5{\%}), skin and soft tissue infection (n=1, 7.7{\%}), meningitis (n=1, 8{\%}), urinary tract infection (n=1, 8{\%}), and intravascular device infection (n=1, 7.7{\%}). Cardiovascular diseases (n=7, 53.8{\%}) were the most common underlying conditions, and diabetes mellitus (n=5, 38.5{\%}) was second. The other co-morbid conditions were hyperlipidemia (n=3, 23.1{\%}), renal disease (n=3, 23.1{\%}), liver disease and/or alcohol abuse (n=3, 23.1{\%}), autoimmune disease or immunosuppressive condition (n=2, 15.5{\%}), malignancy (n=2, 15.5{\%}), respiratory disease (n=1, 8{\%}), and postpartum condition (n=1, 8{\%}), as well as miscellaneous conditions including intravenous drug abuse, HIV infection, and trauma (n=2, 15.5{\%}). Polymicrobial bacteremia was found in five (45.4{\%}) cases and Staphylococcus aureus was the most common concurrent bacterial isolate. Of the 18 GBS isolates in both adults and neonates, serotype Ia was predominant (38.9{\%}), followed by VI (27.8{\%}), V (11.1{\%}), and III (5.5{\%}); the remaining 16.7{\%} were non-typeable. Conclusions: GBS bacteremia is a significant problem and is associated with serious underlying disease, which may result in a high rate of mortality, not only in neonates and pregnant women, but also in non-pregnant adults.",
keywords = "Adult, Bacteremia, GBS, Malaysia, Neonate",
author = "N. Eskandarian and V. Neela and Zalina Ismail and Puzi, {S. M.} and Hamat, {R. A.} and Desa, {M. N M} and Nordin, {S. A.}",
year = "2013",
month = "9",
doi = "10.1016/j.ijid.2013.01.011",
language = "English",
volume = "17",
journal = "International Journal of Infectious Diseases",
issn = "1201-9712",
publisher = "Elsevier",
number = "9",

}

TY - JOUR

T1 - Group B streptococcal bacteremia in a major teaching hospital in Malaysia

T2 - A case series of eighteen patients

AU - Eskandarian, N.

AU - Neela, V.

AU - Ismail, Zalina

AU - Puzi, S. M.

AU - Hamat, R. A.

AU - Desa, M. N M

AU - Nordin, S. A.

PY - 2013/9

Y1 - 2013/9

N2 - Background: Group B Streptococcus (GBS) is a leading cause of infections such as meningitis and septicemia in neonates and pregnant women; however the significance of invasive GBS disease has not been clearly defined in non-pregnant adults. Methods: We reviewed the hospital records of 18 cases with GBS bacteremia who attended the Universiti Kebangsaan Malaysia Medical Centre from June 2010 to October 2011. We analyzed the clinical findings of both bacteremic adults and neonates and compared them to previous studies of GBS bacteremia. Serotyping was done by latex agglutination test using 10 distinct antisera (Ia, Ib, and II-IX). Results: During the period of 1 year and 4 months, there were 18 patients with GBS bacteremia. Five cases occurred in neonates, one in a parturient woman, and 12 in other adults. All neonates with bacteremia were males and two of them were premature. Septicemia was the most common clinical presentation in neonates. They were treated with intravenous (IV) penicillin G and gentamicin. The adults included nine men (69%) and four women (31%). Their mean age was 60 years and all patients had more than two underlying conditions. The most common clinical syndrome was pneumonia (n=6, 46.5%). The others were peritonitis (n=3, 23.1%), primary bacteremia (n=2, 15.5%), septic arthritis (n=2, 15.5%), skin and soft tissue infection (n=1, 7.7%), meningitis (n=1, 8%), urinary tract infection (n=1, 8%), and intravascular device infection (n=1, 7.7%). Cardiovascular diseases (n=7, 53.8%) were the most common underlying conditions, and diabetes mellitus (n=5, 38.5%) was second. The other co-morbid conditions were hyperlipidemia (n=3, 23.1%), renal disease (n=3, 23.1%), liver disease and/or alcohol abuse (n=3, 23.1%), autoimmune disease or immunosuppressive condition (n=2, 15.5%), malignancy (n=2, 15.5%), respiratory disease (n=1, 8%), and postpartum condition (n=1, 8%), as well as miscellaneous conditions including intravenous drug abuse, HIV infection, and trauma (n=2, 15.5%). Polymicrobial bacteremia was found in five (45.4%) cases and Staphylococcus aureus was the most common concurrent bacterial isolate. Of the 18 GBS isolates in both adults and neonates, serotype Ia was predominant (38.9%), followed by VI (27.8%), V (11.1%), and III (5.5%); the remaining 16.7% were non-typeable. Conclusions: GBS bacteremia is a significant problem and is associated with serious underlying disease, which may result in a high rate of mortality, not only in neonates and pregnant women, but also in non-pregnant adults.

AB - Background: Group B Streptococcus (GBS) is a leading cause of infections such as meningitis and septicemia in neonates and pregnant women; however the significance of invasive GBS disease has not been clearly defined in non-pregnant adults. Methods: We reviewed the hospital records of 18 cases with GBS bacteremia who attended the Universiti Kebangsaan Malaysia Medical Centre from June 2010 to October 2011. We analyzed the clinical findings of both bacteremic adults and neonates and compared them to previous studies of GBS bacteremia. Serotyping was done by latex agglutination test using 10 distinct antisera (Ia, Ib, and II-IX). Results: During the period of 1 year and 4 months, there were 18 patients with GBS bacteremia. Five cases occurred in neonates, one in a parturient woman, and 12 in other adults. All neonates with bacteremia were males and two of them were premature. Septicemia was the most common clinical presentation in neonates. They were treated with intravenous (IV) penicillin G and gentamicin. The adults included nine men (69%) and four women (31%). Their mean age was 60 years and all patients had more than two underlying conditions. The most common clinical syndrome was pneumonia (n=6, 46.5%). The others were peritonitis (n=3, 23.1%), primary bacteremia (n=2, 15.5%), septic arthritis (n=2, 15.5%), skin and soft tissue infection (n=1, 7.7%), meningitis (n=1, 8%), urinary tract infection (n=1, 8%), and intravascular device infection (n=1, 7.7%). Cardiovascular diseases (n=7, 53.8%) were the most common underlying conditions, and diabetes mellitus (n=5, 38.5%) was second. The other co-morbid conditions were hyperlipidemia (n=3, 23.1%), renal disease (n=3, 23.1%), liver disease and/or alcohol abuse (n=3, 23.1%), autoimmune disease or immunosuppressive condition (n=2, 15.5%), malignancy (n=2, 15.5%), respiratory disease (n=1, 8%), and postpartum condition (n=1, 8%), as well as miscellaneous conditions including intravenous drug abuse, HIV infection, and trauma (n=2, 15.5%). Polymicrobial bacteremia was found in five (45.4%) cases and Staphylococcus aureus was the most common concurrent bacterial isolate. Of the 18 GBS isolates in both adults and neonates, serotype Ia was predominant (38.9%), followed by VI (27.8%), V (11.1%), and III (5.5%); the remaining 16.7% were non-typeable. Conclusions: GBS bacteremia is a significant problem and is associated with serious underlying disease, which may result in a high rate of mortality, not only in neonates and pregnant women, but also in non-pregnant adults.

KW - Adult

KW - Bacteremia

KW - GBS

KW - Malaysia

KW - Neonate

UR - http://www.scopus.com/inward/record.url?scp=84881556036&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84881556036&partnerID=8YFLogxK

U2 - 10.1016/j.ijid.2013.01.011

DO - 10.1016/j.ijid.2013.01.011

M3 - Article

VL - 17

JO - International Journal of Infectious Diseases

JF - International Journal of Infectious Diseases

SN - 1201-9712

IS - 9

ER -