Incidence, clinical characteristics, and outcomes of Streptococcus dysgalactiae subspecies equisimilis bacteremia in a tertiary hospital: comparison with S. agalactiae bacteremia

Eur J Clin Microbiol Infect Dis. 2019 Dec;38(12):2253-2258. doi: 10.1007/s10096-019-03667-z. Epub 2019 Aug 7.

Abstract

The clinical characteristics and outcomes of Streptococcus dysgalactiae subspecies equisimilis (SDSE) bacteremia cases have not been adequately evaluated. We retrospectively enrolled consecutive adult patients with SDSE or S. agalactiae (group B streptococci, GBS) bacteremia at a tertiary care hospital (Republic of Korea) from August 2012 to December 2016. We compared the incidence, seasonality, clinical characteristics, and outcomes of 52 SDSE bacteremia cases with 151 GBS bacteremia cases. The incidence of SDSE and GBS bacteremia in these patients was 1.28/100,000 and 4.22/100,000 person-days, respectively. Most SDSE bacteremia cases were of community-onset infection (SDSE 94.2% vs GBS 83.4%; p = 0.052). Lancefield group G was the most common bacteria type among SDSE isolates (43/47; 91.5%). Patients with SDSE bacteremia were older (median, 68.0 years vs 61.0 years; p = 0.03). In both groups, solid tumor was the most common underlying disease, and more than half of the patients were immunocompromised (51.9% vs 54.3%; p = 0.77). Chronic kidney disease was more common in the SDSE group (19.2% vs 5.3%; p < 0.01). Cellulitis was the most common clinical syndrome of SDSE bacteremia and was more common in the SDSE group (59.6% vs 29.1%; p < 0.01). SDSE bacteremia cases occurred more frequently in the warm season compared with GBS bacteremia cases (65.4% vs 37.1%; p < 0.01); in-hospital mortalities were not significantly different between the groups (3.8% vs 10.6%; p = 0.17). In conclusion, SDSE bacteremia is commonly associated with cellulitis, especially in older and immunocompromised patients during the warm season.

Keywords: Bacteremia; Cellulitis; Streptococcus agalactiae; Streptococcus dysgalactiae.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Anti-Bacterial Agents / pharmacology
  • Bacteremia / epidemiology*
  • Bacteremia / microbiology*
  • Bacteremia / pathology
  • Female
  • Humans
  • Incidence
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Republic of Korea / epidemiology
  • Retrospective Studies
  • Risk Factors
  • Streptococcal Infections / epidemiology*
  • Streptococcal Infections / microbiology*
  • Streptococcal Infections / pathology
  • Streptococcus / classification
  • Streptococcus / drug effects
  • Streptococcus / isolation & purification*
  • Streptococcus agalactiae / classification
  • Streptococcus agalactiae / drug effects
  • Streptococcus agalactiae / isolation & purification*
  • Tertiary Care Centers

Substances

  • Anti-Bacterial Agents

Supplementary concepts

  • Streptococcus dysgalactiae subsp. equisimilis