Invasive group B streptococcal disease in an orthopaedic unit

Summary Invasive group B streptococcus (GBS) is an increasing cause of infection in orthopaedic patients. Risk factors include increasing age, diabetes mellitus and immune deficiency. It may cause native and periprosthetic joint sepsis, cellulitis, fasciitis, soft tissue abscesses and osteomyelitis....

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Bibliographic Details
Published in:The Journal of hospital infection 2010-11, Vol.76 (3), p.231-233
Main Authors: Jenkins, P.J, Clement, N.D, Gaston, P, Breusch, S, Simpson, H, Dave, J
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Bacterial diseases
Biological and medical sciences
Female
General aspects
Group B streptococcus
Hospital Units - statistics & numerical data
Human bacterial diseases
Human infectious diseases. Experimental studies and models
Humans
Incidence
Infectious Disease
Infectious diseases
Male
Medical sciences
Middle Aged
Orthopedics
Osteomyelitis - epidemiology
Osteomyelitis - microbiology
Postoperative infection
Prevalence
Prosthesis-Related Infections - epidemiology
Prosthesis-Related Infections - microbiology
Soft tissue infection
Soft Tissue Infections - epidemiology
Soft Tissue Infections - microbiology
Staphylococcal infections, streptococcal infections, pneumococcal infections
Streptococcal Infections - epidemiology
Streptococcal Infections - microbiology
Streptococcus
Streptococcus agalactiae
Streptococcus agalactiae - isolation & purification
Surgical site infection
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Summary:Summary Invasive group B streptococcus (GBS) is an increasing cause of infection in orthopaedic patients. Risk factors include increasing age, diabetes mellitus and immune deficiency. It may cause native and periprosthetic joint sepsis, cellulitis, fasciitis, soft tissue abscesses and osteomyelitis. We describe the epidemiology and outcome from GBS infection in a large cohort of general orthopaedic patients. All those presenting to our institution with deep tissue or aspirate samples containing group B streptococcus over three years were identified and their case records examined retrospectively. There were 17 cases, giving an annual incidence of 0.69 per 100 000 adult population. They comprised 0.12% of all emergency admissions. Eight were related to joint prostheses, giving an incidence of 0.15% following joint replacement. Other infections related to underlying metalwork, osteomyelitis or chronic soft tissue infection. All the isolates were susceptible to benzylpenicillin, but six demonstrated intermediate resistance to macrolides. Sixteen patients required surgical debridement, and two ultimately required amputations. This study should raise awareness of GBS as a potential infectious agent in soft tissue and joint infections in patients with specific risk factors.
ISSN:0195-6701
1532-2939
DOI:10.1016/j.jhin.2010.06.011