Recurrence of Streptococcus agalactiae bacteremia - risk factors and complications.

BACKGROUND

This study was undertaken to investigate the incidence and risk factors for Streptococcus agalactiae (GBS) bacteremia recurrence in patients following first episode of GBS bacteremia.

METHODS

This was a retrospective observational study evaluating admitted patients from January 1, 2016 to 12/31/2019. Non-pregnant patients ≥18 years old with GBS bacteremia were included. Recurrence was defined as admission due to GBS bacteremia within 1 year after a positive GBS blood culture.

RESULTS

Nineteen out of 388 patients with GBS bacteremia had recurrence. There was a significant increase in recurrence in patients allergic to β-lactams, in patients with implantable cardiac devices (ICDs), and in patients who did not receive β-lactams or vancomycin as empiric treatment. The estimated odds of recurrence in patients with allergy to β-lactams was 3.1 times the odds of recurrence without allergy after adjusting for ICD status (95 % CI, 1.1-8.9, p < 0.04). The estimated odds for recurrence in patients with ICDs were 5.8 times the odds of patients without ICDs controlling for β-lactam allergy (95 % CI, 1.7-19.9, p < 0.01).

CONCLUSIONS

Our study suggests that GBS bacteremia recurrence is associated with presence of ICDs, β-lactam allergy, and not having received β-lactams or vancomycin as initial treatment.