アブストラクト
Japanese
| Title | Streptococcus agalactiae菌血症の臨床的特徴の解析 |
|---|---|
| Subtitle | 資料 |
| Authors | 加藤雄大1), 松本美咲1), 杉山裕衣1), 松久保修1), 永田悠起1), 木村有里1), 田中浩一1) |
| Authors (kana) | |
| Organization | 1)JA愛知厚生連豊田厚生病院診療協同部臨床検査室 |
| Journal | 医学検査 |
| Volume | 72 |
| Number | 4 |
| Page | 605-613 |
| Year/Month | 2023 / 10 |
| Article | 報告 |
| Publisher | 日本臨床衛生検査技師会 |
| Abstract | 「要旨」Streptococcus agalactiae(Group B streptococcal; GBS)は高齢者や基礎疾患を有する成人の侵襲性感染症の原因菌として報告が増加しており, 死亡率は8.47〜11.58%程度と報告されている. 中でも菌血症患者は非菌血症患者に比較して致死率が高いことが知られているが, GBS菌血症のみに着目した報告は少ないため, GBS菌血症を後方視的に解析した. 2015年1月から2021年12月にかけて血液培養が陽性となったGBS菌血症の15歳以上の症例を対象とした. 期間中にGBS菌血症を呈した症例は69症例であり, 60歳以上に多く発生(88.4%)し, 特に糖尿病(33.3%)や肝硬変(23.1%), 悪性腫瘍(18.8%)の存在が発症に関連していた. また, 尿路感染症(27.5%)や皮膚軟部組織感染症(27.5%)を起因としたGBS菌血症やフォーカス不明の血流感染症(24.6%)によりGBS菌血症が多く発生しており, 死亡率は8.7%であった. GBSの薬剤感受性試験結果ではマクロライド系抗菌薬やニューキノロン系抗菌薬に耐性を示す株が多く, 多剤耐性PRGBSの症例についても2例認めた. PCGはGBS菌血症の第一選択薬として十分な効果は期待できるが, 一方でPRGBSの存在もわずかではあるが考慮しなければならないことが明らかになった. |
| Practice | 医療技術 |
| Keywords | Streptococcus agalactiae, GBS菌血症, 死亡リスク因子, GBS薬剤感受性, PRGBS, GBS bacteremia, mortality risk factors, GBS antimicrobial susceptibility |
English
| Title | Clinical characteristics of group B streptococcal bacteremia |
|---|---|
| Subtitle | Material |
| Authors | Yuta KATOU1), Misaki MATSUMOTO1), Yui SUGIYAMA1), Osamu MATSUKUBO1), Yuki NAGATA1), Yuri KIMURA1), Kouichi TANAKA1) |
| Authors (kana) | |
| Organization | 1)Department of Clinical Laboratory, Toyota Kosei Hospital |
| Journal | Japanese Journal of Medical Technology |
| Volume | 72 |
| Number | 4 |
| Page | 605-613 |
| Year/Month | 2023 / 10 |
| Article | Report |
| Publisher | Japanese Association of Medical Technologists |
| Abstract | [Summary] Streptococcus agalactiae is increasingly reported as a causative agent of invasive infections [namely, group B streptococcal (GBS) bacteremia] in the elderly and adults with underlying diseases, with mortality rates ranging from 8.47 to 11.58%. In particular, bacteremic patients have a higher mortality rate than nonbacteremic patients, but because there are few reports focusing exclusively on GBS bacteremia, we examined GBS bacteremia retrospectively. We studied GBS bacteremia in 15 years and older from January 2015 to December 2021. Sixty-nine patients were found to have GBS bacteremia during this period, and the disease occurred more frequently in patients aged 60 years or older (88.4%), particularly in relation to the presence of diabetes mellitus (33.3%), liver cirrhosis (23.1%), and solid tumor (18.8%). GBS bacteremia was frequently caused by urinary tract infections (27.5%), skin and soft tissue infections (27.5%), and bloodstream infections of unknown focus (24.6%). The mortality rate of GBS bacteremia was 8.7%. The results of drug susceptibility testing of GBS strains showed that many of them were resistant to macrolide and new quinolone antibacterial agents, and two cases of GBS clinical isolates with reduced penicillin susceptibility (PRGBS) were also observed. PCG can be fully effective as a first-line drug for GBS bacteremia, but on the other hand, the presence of PRGBS must also be taken into account, albeit slightly. |
| Practice | Medical technology |
| Keywords | Streptococcus agalactiae, GBS bacteremia, mortality risk factors, GBS antimicrobial susceptibility, PRGBS |
- 全文ダウンロード： 従量制、基本料金制の方共に770円(税込) です。
参考文献
- 1) Rosa-Fraile M et al.: Reliable detection of group B Streptococcus in the clinical laboratory. J Clin Microbiol, 2017; 55: 2590-2598.
- 2) Navarro-Torne A et al.: Burden of invasive group B Strepococcus disease in non-pregnant adults: A systematic review and meta-analysis. PLoS One, 2021; 16: e0258030.
- 3) Matsubara K, Yamamoto G: Invasive group B streptococcal infections in a tertiary care hospital between 1998 and 2007 in Japan. Int J Infect Dis, 2009; 13: 679-684.
- 4) Morozumi M et al.: Molecular characteristics of group B streptococci isolated from adults with invasive infections in Japan. J Clin Microbiol, 2016; 54: 2695-2700.
- 5) Fujiya Y et al.: Age-related differences in clinical characteristics of invasive group G streptococcal infection: Comparison with group A and group B streptococcal infections. PLoS One, 2019; 14: e0211786.
残りの13件を表示する
- 6) Vasikasin V, Dhitiwat C: Clinical manifestations and prognostic factors for Streptococcus agalactiae bacteremia among nonpregnant adults in Thailand. J Infect Chemother, 2021; 27: 967-971.
- 7) Huang P et al.: Group B streptococcal bacteremia in non-pregnant adults. J Microbiol Immunol Infect, 2006; 39: 237-241.
- 8) Ho C et al.: Clinical characteristics of group B streptococcus bacteremia in non-pregnant adults. J Microbiol Immunol Infect, 2006; 39: 396-401.
- 9) Clinical and Laboratory Standards Institute: Performances standards for antimicrobial susceptibility testing; 32nd informational supplement(M100-Ed32).
- 10) Phares C et al.: Epidemiology of invasive group B streptococcal disease in the United States, 1999-2005. JAMA, 2008; 299: 2056-2065.
- 11) Dadvand P et al.: Climate and group B streptococci colonisation during pregnancy: Present implications and future concerns. BJOG, 2011; 118: 1396-1400.
- 12) Chaiwarith R et al.: Streptococcus agalactiae in adults at Chiang Mai University Hospital: A retrospective study. BMC Infect Dis, 2011; 11: 1-7.
- 13) Lamagni TL et al.: Emerging trends in the epidemiology of invasive group B streptococcal disease in England and Wales, 1991-2010. Clin Infect Dis, 2013; 57: 682-688.
- 14) Bjornsdottir ES et al.: Changing epidemiology of group B streptococcal infections among adults in Iceland: 1975-2014. Clin Microbiol Infect, 2016; 22: 379.
- 15) Lin HC et al.: Clonal dissemination of invasive and colonizing clonal complex 1 of serotype VI group B Streptococcus in central Taiwan. J Microbiol Immunol Infect, 2016; 49: 902-909.
- 16) Skoff TH et al.: Increasing burden of invasive group B streptococcal disease in nonpregnant adults, 1990-2007. Clin Infect Dis, 2009; 49: 85-92.
- 17) Tazi A et al.: Infect, 2011; 17: 1587-1589.
- 18) Kimura K et al.: High frequency of fluoroquinolone-and macrolide-resistant streptococci among clinically isolated group B streptococci with reduced penicillin susceptibility. J Antimicrob Chemother, 2013; 68: 539-542.
