Objectives: The epidemiology of disease caused by group B Streptococcus (GBS; Streptococcus agalactiae)outside pregnancy and the neonatal period is poorly characterized. The aim of this study was to quantify the role of GBS as a cause of surgical site and non-invasive infections at all ages. Methods: A systematic review (PROSPERO CRD42017068914)and meta-analysis of GBS as a proportion (%)of bacterial isolates from surgical site infection (SSI), skin/soft tissue infection (SSTI), urinary tract infection (UTI), and respiratory tract infection (RTI)was conducted. Results: Seventy-four studies and data sources were included, covering 67 countries. In orthopaedic surgery, GBS accounted for 0.37% (95% confidence interval (CI)0.08–1.68%), 0.87% (95% CI 0.33–2.28%), and 1.46% (95% CI 0.49–4.29%)of superficial, deep, and organ/space SSI, respectively. GBS played a more significant role as a cause of post-caesarean section SSI, detected in 2.92% (95% CI 1.51–5.55%), 1.93% (95% CI 0.97–3.81%), and 9.69% (95% CI 6.72–13.8%)of superficial, deep, and organ/space SSI. Of the SSTI isolates, 1.89% (95% CI 1.16–3.05%)were GBS. The prevalence of GBS in community and hospital UTI isolates was 1.61% (1.13–2.30%)and 0.73% (0.43–1.23%), respectively. GBS was uncommonly associated with RTI, accounting for 0.35% (95% CI 0.19–0.63%)of community and 0.27% (95% CI 0.15–0.48%)of hospital RTI isolates. Conclusions: GBS is implicated in a small proportion of surgical site and non-invasive infections, but a substantial proportion of invasive SSI post-caesarean section.
Bibliographical noteFunding Information:
This work was supported by Pfizer Inc. The funder had no role in the study design, data collection, data analysis, data interpretation, or writing of the report. The corresponding author had full access to the data in the study and final responsibility for the decision to submit this paper.
© 2019 The Authors
- Respiratory tract infection
- Skin and soft tissue infection
- Streptococcus agalactiae
- Surgical site infection
- Urinary tract infection