Cargando…

206. Variations in the frequency and impact of polymicrobial cultures in adults with invasive Group B Streptococcal (GBS) infection at the US Veterans Health Administration

BACKGROUND: GBS, a colonizer of human skin, genitourinary and gastrointestinal tracts, is responsible for increasing rates of invasive infection among non-pregnant adults in the United States. GBS is often isolated with other bacteria; however, the clinical significance of polymicrobial cultures in...

Descripción completa

Detalles Bibliográficos
Autores principales: Briggs, Janet, Wilson, Brigid, Zappernick, Taissa, Banks, Richard, Baechle2; Sunah Song, Daniel, Jump, Robin L, Perez, Federico
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6810765/
http://dx.doi.org/10.1093/ofid/ofz360.281
_version_ 1783462322776309760
author Briggs, Janet
Wilson, Brigid
Zappernick, Taissa
Banks, Richard
Baechle2; Sunah Song, Daniel
Jump, Robin L
Perez, Federico
author_facet Briggs, Janet
Wilson, Brigid
Zappernick, Taissa
Banks, Richard
Baechle2; Sunah Song, Daniel
Jump, Robin L
Perez, Federico
author_sort Briggs, Janet
collection PubMed
description BACKGROUND: GBS, a colonizer of human skin, genitourinary and gastrointestinal tracts, is responsible for increasing rates of invasive infection among non-pregnant adults in the United States. GBS is often isolated with other bacteria; however, the clinical significance of polymicrobial cultures in patients with invasive GBS infection is unknown. Our aim was to characterize polymicrobial cultures in patients with invasive GBS infection and explore their impact on mortality at 30 days. METHODS: Within the VHA Corporate Data Warehouse, we identified veterans active in VHA between 2008–2017 with invasive GBS infection according to CDC’s surveillance definitions. Reports of cultures from blood, bone and sterile fluid with GBS were assessed for the presence of other bacteria.We used International Classification of Disease (ICD) codes to define the type of invasive GBS infection. We compared 30-day all-cause mortality between patients with cultures that identified only GBS (monomicrobial cases) and patients with cultures that identified GBS and other bacteria (polymicrobial cases). RESULTS: Of 4780 incident cases of invasive GBS infection identified between 2008–2017, 1204 (25%) were polymicrobial. The proportion of polymicrobial cases varied by type of invasive GBS infection, ranging from 58% in osteomyelitis to 10–15%in meningitis, endocarditis, skin and soft-tissue infections, and septic arthritis (table). Staphylococcus aureuswas found in 516 (43%) of polymicrobial cases;there were variations in the bacteria isolated by type of infection (figure). Overall, there was no difference in 30-day mortality between polymicrobial and monomicrobial cases of invasive GBS infection (both 8%). However, when compared with monomicrobial cases, 30-day mortality was doubled in polymicrobial cases of pneumonia and bacteremia (15% vs. 31% and 11% vs. 22%, respectively). CONCLUSION: The frequency, composition and mortality of polymicrobial cases vary according to the type of invasive GBS infection. Polymicrobial infection could be an important determinant of outcome in certain invasive GBS infections. The effect of polymicrobial infection involving GBS, relative to age, severity of illness and underlying comorbidities, needs further exploration. [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures.
format Online
Article
Text
id pubmed-6810765
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-68107652019-10-28 206. Variations in the frequency and impact of polymicrobial cultures in adults with invasive Group B Streptococcal (GBS) infection at the US Veterans Health Administration Briggs, Janet Wilson, Brigid Zappernick, Taissa Banks, Richard Baechle2; Sunah Song, Daniel Jump, Robin L Perez, Federico Open Forum Infect Dis Abstracts BACKGROUND: GBS, a colonizer of human skin, genitourinary and gastrointestinal tracts, is responsible for increasing rates of invasive infection among non-pregnant adults in the United States. GBS is often isolated with other bacteria; however, the clinical significance of polymicrobial cultures in patients with invasive GBS infection is unknown. Our aim was to characterize polymicrobial cultures in patients with invasive GBS infection and explore their impact on mortality at 30 days. METHODS: Within the VHA Corporate Data Warehouse, we identified veterans active in VHA between 2008–2017 with invasive GBS infection according to CDC’s surveillance definitions. Reports of cultures from blood, bone and sterile fluid with GBS were assessed for the presence of other bacteria.We used International Classification of Disease (ICD) codes to define the type of invasive GBS infection. We compared 30-day all-cause mortality between patients with cultures that identified only GBS (monomicrobial cases) and patients with cultures that identified GBS and other bacteria (polymicrobial cases). RESULTS: Of 4780 incident cases of invasive GBS infection identified between 2008–2017, 1204 (25%) were polymicrobial. The proportion of polymicrobial cases varied by type of invasive GBS infection, ranging from 58% in osteomyelitis to 10–15%in meningitis, endocarditis, skin and soft-tissue infections, and septic arthritis (table). Staphylococcus aureuswas found in 516 (43%) of polymicrobial cases;there were variations in the bacteria isolated by type of infection (figure). Overall, there was no difference in 30-day mortality between polymicrobial and monomicrobial cases of invasive GBS infection (both 8%). However, when compared with monomicrobial cases, 30-day mortality was doubled in polymicrobial cases of pneumonia and bacteremia (15% vs. 31% and 11% vs. 22%, respectively). CONCLUSION: The frequency, composition and mortality of polymicrobial cases vary according to the type of invasive GBS infection. Polymicrobial infection could be an important determinant of outcome in certain invasive GBS infections. The effect of polymicrobial infection involving GBS, relative to age, severity of illness and underlying comorbidities, needs further exploration. [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2019-10-23 /pmc/articles/PMC6810765/ http://dx.doi.org/10.1093/ofid/ofz360.281 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Briggs, Janet
Wilson, Brigid
Zappernick, Taissa
Banks, Richard
Baechle2; Sunah Song, Daniel
Jump, Robin L
Perez, Federico
206. Variations in the frequency and impact of polymicrobial cultures in adults with invasive Group B Streptococcal (GBS) infection at the US Veterans Health Administration
title 206. Variations in the frequency and impact of polymicrobial cultures in adults with invasive Group B Streptococcal (GBS) infection at the US Veterans Health Administration
title_full 206. Variations in the frequency and impact of polymicrobial cultures in adults with invasive Group B Streptococcal (GBS) infection at the US Veterans Health Administration
title_fullStr 206. Variations in the frequency and impact of polymicrobial cultures in adults with invasive Group B Streptococcal (GBS) infection at the US Veterans Health Administration
title_full_unstemmed 206. Variations in the frequency and impact of polymicrobial cultures in adults with invasive Group B Streptococcal (GBS) infection at the US Veterans Health Administration
title_short 206. Variations in the frequency and impact of polymicrobial cultures in adults with invasive Group B Streptococcal (GBS) infection at the US Veterans Health Administration
title_sort 206. variations in the frequency and impact of polymicrobial cultures in adults with invasive group b streptococcal (gbs) infection at the us veterans health administration
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6810765/
http://dx.doi.org/10.1093/ofid/ofz360.281
work_keys_str_mv AT briggsjanet 206variationsinthefrequencyandimpactofpolymicrobialculturesinadultswithinvasivegroupbstreptococcalgbsinfectionattheusveteranshealthadministration
AT wilsonbrigid 206variationsinthefrequencyandimpactofpolymicrobialculturesinadultswithinvasivegroupbstreptococcalgbsinfectionattheusveteranshealthadministration
AT zappernicktaissa 206variationsinthefrequencyandimpactofpolymicrobialculturesinadultswithinvasivegroupbstreptococcalgbsinfectionattheusveteranshealthadministration
AT banksrichard 206variationsinthefrequencyandimpactofpolymicrobialculturesinadultswithinvasivegroupbstreptococcalgbsinfectionattheusveteranshealthadministration
AT baechle2sunahsongdaniel 206variationsinthefrequencyandimpactofpolymicrobialculturesinadultswithinvasivegroupbstreptococcalgbsinfectionattheusveteranshealthadministration
AT jumprobinl 206variationsinthefrequencyandimpactofpolymicrobialculturesinadultswithinvasivegroupbstreptococcalgbsinfectionattheusveteranshealthadministration
AT perezfederico 206variationsinthefrequencyandimpactofpolymicrobialculturesinadultswithinvasivegroupbstreptococcalgbsinfectionattheusveteranshealthadministration