Group B streptococcal bacteremia in non-pregnant adults: results from two Korean centers.

Abstract

Patients with liver cirrhosis (LC) have impaired immunity and are, thus, predisposed to infection. Few studies have attempted to evaluate group B streptococcal (GBS) bacteremia in LC patients. A retrospective study of patients with GBS bacteremia was performed at the Dongguk University Ilsan Hospital and National Health Insurance Service Ilsan Hospital over a 13-year period (October 2000 to July 2013). During the study period, 97 patients with GBS bacteremia were enrolled. The median age of the patients was 67 years and 54% were men. Among them, 23 (24%) patients were classified as LC patients. The 30-day mortality rate of LC patients was significantly higher than that of patients with other diseases (26% vs. 8%, p = 0.03). The multivariate analysis indicated that LC was associated with an increased risk of 30-day mortality [hazard ratio (HR) 5.0; 95% confidence interval (CI) 1.53-16.3; p = 0.008], as well as age (HR 1.07; 95% CI 1.03-1.13; p = 0.02) and high Pitt bacteremia score (HR 1.23; 95% CI 1.02-1.46; p = 0.03). The probability of survival at day 30 was significantly different for the Child-Pugh class C and the Child-Pugh classes A or B (44% vs. 93%, respectively; p = 0.01 by the log-rank test). The mortality rates of LC patients with GBS bacteremia were significantly higher than those of patients with other diseases. The severity of hepatic dysfunction plays an important role in the development of adverse events. Cirrhosis-specific scores such as the Child-Pugh class might be useful for predicting the prognosis of GBS bacteremia in LC patients.