Group B streptococcal disease in nonpregnant adults

Group B streptococcal (GBS) disease in nonpregnant adults is increasing, pa rticularly in elderly persons and those with significant underlying disease s. Diabetes, neurological impairment, and cirrhosis increase risk for invas ive GBS disease. Skin, soft-tissue, and osteoarticular infections, pneumoni a, and urosepsis are common presentations. Meningitis and endocarditis are less common but associated with serious morbidity and mortality. Disease is frequently nosocomial and may be related to the placement of an iv cathete r. Recurrent infection occurs in 4.3% of survivors. Capsular serotypes Ia, III, and V account for the majority of disease in nonpregnant adults. Altho ugh group B streptococci are susceptible to penicillin, minimum inhibitory concentrations are 4-fold to 8-fold higher than for group A streptococci. R esistance to erythromycin and clindamycin is increasing. The role of antibo dies in protection against GBS disease in nonpregnant adults is unresolved. However, the immunogenicity of GBS vaccines being developed for prevention of neonatal disease should be assessed for adults who are at risk.