Clinical Disease and Outcomes of Group B Streptococcus Bloodstream Infections at a Teaching Hospital in Saudi Arabia From 2015 to 2022

Abstract

Background Invasive disease due to group B Streptococcus (GBS) infection in adult males and nonpregnant females can cause various diseases, such as primary bacteremia, endocarditis, skin and soft tissue infection (SSTI), and meningitis. Especially in older people, invasive GBS infection has a high case fatality rate. In Saudi Arabia, little is known about the clinical signs and symptoms of GBS bacteremia and the associated risk factors and mortality rate. Methodology We performed a retrospective study at King Abdulaziz University Hospital in Jeddah, Saudi Arabia, a large tertiary hospital, to investigate clinical disease, potential risk factors, susceptibility patterns, and mortality related to GBS in adult males and nonpregnant females diagnosed with GBS bacteremia. All patients ≥14 years of age with GBS-positive blood cultures from January 1, 2015, until December 31, 2022, were included. Patient data such as age, sex, comorbidities, hospital ward, length of hospital stay, monomicrobial versus polymicrobial bloodstream infection, antimicrobials used for treatment, complications, whether an infectious disease specialist had seen them, and outcomes were extracted from the electronic health records. Results A total of 50 patients with GBS bacteremia met the inclusion criteria. The mean age of these patients was 57.0 years (SD = 16.0), and 27 (54%) were female. The 90-day mortality was 11 (22%). In total, 34 (68%) patients had a monomicrobial infection, and among those with polymicrobial infection, methicillin-resistant Staphylococcus aureus was the most common co-infection (56%, n = 9/16). The most common source of infection was SSTI and wound infection in 24 (48%) patients. Most patients had one or more comorbidities; the mean Charlson comorbidity index was 3.8 (SD = 2.4). The most prevalent comorbidity was diabetes mellitus in 35 (70%) patients. Of all variables analyzed, only age was significantly associated with mortality (p = 0.016), and age had a predictive value for mortality (p = 0.035). Conclusions In Saudi Arabia, as in other countries, GBS is an important pathogen, especially in older people, that should be considered when encountering a patient with bacteremia. In addition, in patients over 65 years old, GBS bacteremia carries a high risk for mortality.