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Original Articles
Clinical Evaluation of Group B Streptococcal Infections in Nonpregnant Adults
U-Seouk Ahn, Kyung-Sik Ko, Sun-Hee Kwon, Weon-Uk Lee, Koo-Yeop Kim, Hwan-Jo Suh
Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea
Vol.27 Num.4 (p371~377)
Background : Several reports have suggested that the incidence of diseases caused by Group B streptococcus is increasing in nonpregnant adults, particularly those with serious underlying diseases. The objectives of this study were to define the clinical manifestations, underlying conditions(risk factors) of definite group B streptococcal diseases in nonpregnant adults and to obtain antimicrobial sensitivity of these infections.
Methods : We analyzed the records of 274 cases of the Group B streptococcus isolated in Kyung-Hee University hospital between 1986 and 1993.
Results:
1) Total Group B streptococcal isolates were 274 cases: Of these cases, 7 percent were 1 month of age or younger, 3 percent were older than 1 month but younger than 18 years of age, and 91 percent were 18 or older.
2) Men and nonpregnant women accounted for 87 percent(n=231): 133 cases(57.6%) with definite infection, 46 cases(19.9%) with possible infection, and 52 cases(22.5%) with no infection. 31 cases of 133(23.3%) nonpregnant adults with definite infection appeared to have acquired the disease nosocomially.
3) In the 133 nonpregnant adult patients, the most common clinical diagnosis were urinary tract infection(28%), and cervicitis(28%).
4) In the 133 nonpregnant adult patients, the underlying diseases or conditions were diabetes mellitus(32%), cerebrovascular accident(21%), hypertension(19%), renal failure(12%), and malignant neoplasm(5%), Sixty-nine percent of the cases had one or more underlying diseases.
5) In the antimicrobial sensitivity tests, 98.4% of isolates were sensitive to penicillin, 99.6% to cephalothin, 98.8% to cefamandol, 96.0% to erythromycin, 89.4% to clindamycin, and 49.4% to minocycline.
6) The case mortality rate was 4.5%(6 of 133).
Conclusion : We found group B streptococcal infection to be a significant and apparently increasing cause of definite diseases in nonpregnant adults, particularly in those with serious underlying diseases. Recognizing these infections early in the groups with serious underlying diseases will be helpful in lowering mortality.

Keywords : Group B Streptococcus, Nonpregnant Adults