S. agalactiae invasive infections in male adults

Abstract number: 1733_562

Makarona M., Tsagarakis N., Moraitou H., Kentrou N., Gioga A., Kapotis C., Pefanis A., Kanavaki S.

Objectives: To investigate S. agalactiae invasive infections in our hospital. In particular, S. agalactiae has been considered a major pathogen in neonates and pregnant women. However, there is accumulating concern about its significance in non-pregnant adults, because it has been recently recognized as an important and increasingly common cause of invasive diseases in the previous. Specifically, it can cause disease in adult patients with underlying medical conditions, including diabetes mellitus, malignancies and liver disease. Skin and soft tissue infections are common presentations of invasive S. agalactiae infections, while nosocomial infections and polymicrobial bacteraemia occur in a significant proportion of patients. The annual incidence of invasive disease has been estimated at 4.4 per 100,000 non-pregnant adults, whereas the incidence of infections due to S. agalactiae has increased among diabetic patients. Mortality rates in invasive diseases are particularly high (20–70%).

Materials: We retrospectively studied 9 cases of systemic infections due to S. agalactiae in male adults, during the last five-year period.

Results: From a total of nine cases of S. agalactiae infection, 6 (66.6%) concerned male patients that had all been hospitalised within this recent year, 2006, in various departments of our hospital. S. agalactiae was isolated and identified in various clinical specimens: blood, pus, cerebrospinal fluid, sputum, urine, pleural effusion and synovial fluid. Five out of nine strains (56%) were responsible for bacteraemia, from which 2/5 where responsible for bacteraemia only, 2/5 for bacteraemia as well as for diabetic foot, while 1/5 was simultaneously isolated in blood and cerebrospinal fluid. Among the others, 1/9 (11.1%) was isolated from pleural effusion, 1/9 (11.1%) from synovial fluid, 1/9 (11.1%) from urine and 1/9 (11.1%) from sputum. Eight out of nine patients (88.9%) were suffering from a serious underlying disease: 4 from diabetes mellitus, 2 from diabetes mellitus and malignancy, 1 had malignancy only, 1 suffered from chronic renal failure, while only 1 had a free previous medical history. One patient died, while all the rest had an improved clinical outcome.

Conclusion:S. agalactiae invasive infections seem to gain ground as a significant problem in male adults, especially in those with chronic diseases, such as diabetes mellitus. Efforts should be made to be identified and treated early for a successful clinical outcome.