Abstract
Previous epidemiology reports on invasive Streptococcus agalactiae (GBS) infections in Denmark did not include all patient age groups. The aim of this study was therefore to analyze the GBS incidence in all age groups during the period 2005–2018 and to present the serotype distribution and the antibiotic susceptibility. Data were retrieved from the Danish laboratory surveillance system, and these included data on typing and susceptibility testing for erythromycin and clindamycin. Early-onset disease (EOD) (mean incidence 0.17 per 1,000 live births) and late-onset disease (LOD) (mean incidence 0.14 per 1,000 live births) showed a low level during the period. The incidence was stable in the age groups 91 days to 4 years, 5–19 years, and 20–64 years. From 2005 to 2018, the incidence in the elderly showed a significantly increasing trend (P < 0.05), that in the 65–74 years increased from 3.23 to 8.34 per 100,000, and that in the 75+ years increased from 6.85 to 16.01 per 100,000. Erythromycin and clindamycin resistance fluctuated over the period; however, the overall trend was increasing. Data showed that EOD and LOD incidence continued to be low, whereas an increasing trend in GBS infections in the elderly was observed. The prevalence of erythromycin and clindamycin resistance increased from 2005 to 2018.
Highlights
Streptococcus agalactiae [Group B Streptococcus (GBS)] is a commensal of the gastrointestinal tract and vagina and has been estimated to colonize the vagina in 10–35% of pregnant women (1)
Isolates from 1,875 unique cases of invasive GBS infection were received, 59 of which were from patients with meningitis (3.1%; 95% CI, 2.44–4.04)
The incidences of early-onset disease (EOD) and late-onset disease (LOD) have been at a steady level since 2005 (Figure 1)
Summary
Streptococcus agalactiae [Group B Streptococcus (GBS)] is a commensal of the gastrointestinal tract and vagina and has been estimated to colonize the vagina in 10–35% of pregnant women (1). GBS is a well-known agent in meningitis and sepsis in newborns, and in recent years, an increasing incidence of GBS infections among the elderly, mainly bacteremia and meningitis, has been observed in the industrialized part of the world (2–4). GBS infections are classified as early-onset disease (EOD; age 0–6 days) or late-onset disease (LOD; age [7–90] days). Based on capsular polysaccharide antigens, 10 different serotypes of GBS have been identified, designated as Ia, Ib, and II–IX (7). The serotype distribution of colonizing GBS varies depending on the geographical region (8). A similar variation is observed regarding invasive GBS serotypes, five serotypes (Ia, Ib, II, III, and V) were predominant worldwide during the period 2000–2017 (9)
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