背景:成年男性和非妊娠女性B族链球菌(GBS)感染引起的侵袭性疾病可引起多种疾病,如原发性菌血症,心内膜炎,皮肤和软组织感染(SSTI),和脑膜炎。尤其是老年人,侵袭性GBS感染具有较高的病死率。在沙特阿拉伯,对GBS菌血症的临床体征和症状以及相关的危险因素和死亡率知之甚少。方法我们在吉达的阿卜杜勒阿齐兹国王大学医院进行了一项回顾性研究,沙特阿拉伯,一家大型三级医院,为了调查临床疾病,潜在风险因素,易感性模式,诊断为GBS菌血症的成年男性和非妊娠女性与GBS相关的死亡率。纳入2015年1月1日至2022年12月31日所有年龄≥14岁的GBS阳性血培养患者。患者数据,如年龄,性别,合并症,医院病房,住院时间,单微生物与多微生物血流感染,用于治疗的抗菌药物,并发症,传染病专家是否看过他们,并从电子健康记录中提取结果。结果共有50例GBS菌血症患者符合纳入标准。这些患者的平均年龄为57.0岁(SD=16.0),27名(54%)为女性。90天死亡率为11(22%)。总的来说,34例(68%)患者有单一抗菌药物感染,在那些患有多微生物感染的人中,耐甲氧西林金黄色葡萄球菌是最常见的合并感染(56%,n=9/16)。最常见的感染源是24例(48%)患者的SSTI和伤口感染。大多数患者有一种或多种合并症;平均Charlson合并症指数为3.8(SD=2.4)。35例(70%)患者中最常见的合并症是糖尿病。在所有分析的变量中,仅年龄与死亡率显着相关(p=0.016),和年龄对死亡率有预测价值(p=0.035).结论在沙特阿拉伯,和其他国家一样,GBS是一种重要的病原体,尤其是老年人,遇到菌血症患者时应该考虑到这一点。此外,65岁以上的患者,GBS菌血症具有很高的死亡风险。
Background Invasive disease due to group B Streptococcus (GBS) infection in adult males and nonpregnant females can cause various diseases, such as primary bacteremia, endocarditis, skin and soft tissue infection (SSTI), and meningitis. Especially in older people, invasive GBS infection has a high case fatality rate. In Saudi Arabia, little is known about the clinical signs and symptoms of GBS bacteremia and the associated risk factors and mortality rate. Methodology We performed a retrospective study at King Abdulaziz University Hospital in Jeddah, Saudi Arabia, a large tertiary hospital, to investigate clinical disease, potential risk factors, susceptibility patterns, and mortality related to GBS in adult males and nonpregnant females diagnosed with GBS bacteremia. All patients ≥14 years of age with GBS-positive blood cultures from January 1, 2015, until December 31, 2022, were included. Patient data such as age, sex, comorbidities, hospital ward, length of hospital stay, monomicrobial versus polymicrobial bloodstream infection, antimicrobials used for treatment, complications, whether an infectious disease specialist had seen them, and outcomes were extracted from the electronic health records. Results A total of 50 patients with GBS bacteremia met the inclusion criteria. The mean age of these patients was 57.0 years (SD = 16.0), and 27 (54%) were female. The 90-day mortality was 11 (22%). In total, 34 (68%) patients had a monomicrobial infection, and among those with polymicrobial infection, methicillin-resistant Staphylococcus aureus was the most common co-infection (56%, n = 9/16). The most common source of infection was SSTI and wound infection in 24 (48%) patients. Most patients had one or more comorbidities; the mean Charlson comorbidity index was 3.8 (SD = 2.4). The most prevalent comorbidity was diabetes mellitus in 35 (70%) patients. Of all variables analyzed, only age was significantly associated with mortality (p = 0.016), and age had a predictive value for mortality (p = 0.035). Conclusions In Saudi Arabia, as in other countries, GBS is an important pathogen, especially in older people, that should be considered when encountering a patient with bacteremia. In addition, in patients over 65 years old, GBS bacteremia carries a high risk for mortality.