Group B streptococcal meningitis in adults: recent increase in Southeast Asia

Background: Meningitis caused by Streptococcus agalactiae (Group B Streptoc occus) is rare in adults and usually affects patients with predisposing con ditions. Aims: To describe an increase in adult group B streptococcal meningitis occ urring in parallel in Hong Kong and Singapore. Methods: All cases of bacterial meningitis admitted to the Prince of Wales Hospital, Hong Kong and Singapore General Hospital in 1998, aged 15 years o r above, were reviewed. Medical records for the previous ten years were sea rched for previous cases of adult group B streptococcal meningitis. Results: In 1998, 29 adult patients with bacterial meningitis were admitted to the two hospitals. S. agalactiae was isolated in 11 cases, Streptococcu s pneumoniae in three cases, Klebsiella pneumoniae in two cases, and Pseudo monas pseudomallei in one case. In 11 cases no bacteriological diagnosis co uld be made. Two patients with adult group B streptococcal meningitis had p redisposing conditions for infection. One patient died before a definite di agnosis could be established. A ten year review of records revealed one pre vious case of adult group B streptococcal meningitis in a patient with mult iple risk factors. Conclusions: An increase of group B streptococcal meningitis has occurred a mong adults admitted to two major hospitals in two Southeast Asian cities. In the majority of cases there were no identifiable predisposing conditions . The cause of this increase of group B streptococcal remains unclear.