Invasive group B streptococcal disease in adults: a population-based study in metropolitan Atlanta

Article Abstract:

Streptococci are bacteria which come in a wide variety of types; many types are classified on the basis of immunological characteristics. Most of the human diseases related to streptococcal infection are caused by group A beta-hemolytic streptococci. However, group B streptococcus may also be a substantial cause of illness and death. Little attention has been paid to documenting the extent of group B disease in the general population. Many of the published studies have focused on group B disease occurring in pregnancy or in the neonatal period. A population-based study was therefore conducted to determine the importance of group B strep infection as a cause of human disease and to identify individuals who may be at greater risk. A total of 70 cases of group B disease were identified; 14 of these cases involved pregnant women. This number of cases works out to an average incidence of 2.4 cases per 100,000 people each year. Almost one third of the cases were fatal. An important finding was that the group B strep infection was almost invariably associated with some other underlying illness. Patients with diabetes are about 10.5 times as likely to suffer group B infection than members of the general population. The risk of group B infection is 16.4 times as high among patients with cancer. The present study also confirmed observations that pregnant women are at increased risk. In contrast with other patients, however, the pregnant women were generally healthy prior to the group B infection. (Consumer Summary produced by Reliance Medical Information, Inc.)

Bacterial infections, Septicemia

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Population-based risk factors for neonatal group B streptococcal disease: results of a cohort study in metropolitan Atlanta

Article Abstract:

Group B streptococci (GBS) are associated with the development of meningitis (inflammation of the membranes surrounding the brain and/or spinal cord) and sepsis (the presence of pathogenic organisms in the blood) in newborn infants. GBS can be transmitted from an infected mother to the fetus. It has been estimated that GBS is present in 25 percent of all pregnant women. Antibiotic therapy has proven to be of little value in treating newborns with GBS. To determine risk factors associated with the development of neonatal GBS, the medical records of all cases of neonatal GBS occurring in Atlanta, between 1982 and 1983, were reviewed. GBS was subdivided into two groups, early onset (occurring within six days of birth) and late onset (occurring more than six days after birth). Seventy-one cases of early onset GBS and 37 cases of late onset GBS were identified in the medical records. The average rate of occurrence of early onset GBS was 1.09 cases of every 1,000 live births, and for late onset GBS, 0.57 cases of every 1,000 live births. The fatality rate for neonatal GBS was 7.5 percent. Mothers who had previous had miscarriages had an increased risk of giving birth to an infant with early onset GBS. Black infants were at greater risk for developing GBS, and accounted for 59 percent of all cases of early onset GBS and 78 percent of the cases of late onset GBS. Early onset GBS was also more likely to occur in newborns weighing less than 5.5 pounds, and in infants born to teenage mothers. (Consumer Summary produced by Reliance Medical Information, Inc.)

Streptococcal infections, Risk factors, Diseases, Infants (Newborn), Disease transmission, Georgia, Neonatal diseases, Atlanta, Georgia

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Use of surveillance for invasive pneumococcal disease to estimate the size of the immunosuppressed HIV-infected population

Article Abstract:

It is important to have an accurate estimate of the number of people who are at risk of developing acquired immunodeficiency syndrome (AIDS) so that better prevention strategies can be designed. Thus far, strategies used to estimate the number of people infected with the human immunodeficiency virus (HIV), the agent that causes AIDS, have suffered from severe drawbacks in methodology. A method was devised to estimate the size of the immunosuppressed HIV-infected population ('pre-AIDS') based on the incidence of Streptococcus pneumoniae, which is normally rare among young and middle-aged adults. Age-, sex-, and race-specific rates of pneumococcal disease were applied to low and high-incidence areas to determine the expected number of infections in counties in New Jersey. AIDS patients between 25 and 44 years of age were more than 300 times more likely to have an attack of invasive pneumococcal disease than noninfected adults, underscoring the need for pneumococcal vaccine early in HIV infection. If effective, pneumococcal vaccination would reduce the accuracy of using pneumococcal surveillance for estimating the size of the pre-AIDS population. Application of this method to other populations will test its validity and usefulness. (Consumer Summary produced by Reliance Medical Information, Inc.)

AIDS (Disease), Streptococcus pneumoniae

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