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Group B Streptococcal Pneumonia in the Elderly

Group B Streptococcal Pneumonia in the Elderly Abstract • Group B streptococcal infections, although well studied in neonates, have only recently been appreciated as important infectious agents in adults. Seven cases of Group B streptococcal pneumonia were verified by transtracheal aspiration, blood and sputum cultures, or multiple stab cultures at autopsy. The infections were largely nosocomial and, ultimately, fatal in all seven patients. Our patients were older (average age, 73 years) and much more debilitated than the 13 cases reported in the literature. Diabetes was less common than previously reported. Previous antibiotic therapy was common. Concomitant isolation of another organism (especially Staphylococcus aureus) occurred in five patients. The morphologic findings at autopsy, in one patient, were characterized by a severely necrotizing destructive process. In our experience, Group B streptococcal pneumonia is more common, more devastating, and occurs in an older population than previously reported. (Arch Intern Med 1982;142:1642-1645) References 1. Eickhoff TC, Klein JO, Daly AK, et al: Neonatal sepsis and other infections due to group B streptococci. N Engl J Med 1964;271:1221-1224.Crossref 2. McCracken GH: Group B streptococcal infections. J Pediatr 1976; 89:203-206.Crossref 3. Braunstain J, Tucker FB, Gibson BC: Identification and significance of Streptococcus agalachiae (Lancefield group B). Am J Clin Pathol 1969; 51:207-214. 4. Butter MNW, deMoor CE: Streptococcus agalachiae as a cause of meningitis in the newborn, and of bacteremia in adults: Differentiation of human and animal varieties. J Microbiol Serol 1967;33:439-450. 5. Finland M: Excursion into epidemiology, selected studies during the past four decades at Boston city hospital. J Infect Dis 1973;128:76-124.Crossref 6. Bayer AS, Chow AW, Anthony BF, et al: Serious infections in adults due to group B streptococci. Am J Med 1976;61:498-502.Crossref 7. Lerner PI, Gopalakrishna KV, Wolinsky E, et al: Group B Streptococcus bacteremia in adults: Analysis of 32 cases and review of the literature. Medicine 1977;56:457-573.Crossref 8. Nicklas JM: Serious group B beta-hemolytic streptococcal infections in adults: Report of two cases and a review of the literature. Johns Hopkins Med J 1978;142:39-45. 9. Dworzack DL, Hodges GR, Barnes WG, et al: Group B streptococcal infections in adult males. Am J Med Sci 1979;277:67-73.Crossref 10. Duma RJ, Weinberg AN, Medrek TF, et al: Streptococcal infections: A bacteriologic and clinical study of streptococcal bacteremia. Medicine 1969;48:78-127.Crossref 11. Berk SL, Holtsclaw MC, Khan A, et al: Transtracheal aspiration in the severely ill elderly patient with bacterial pneumonia. J Am Geriatr Soc 1981;29:228-231. 12. Berk SL, Wiener SL, Eisner LB, et al: Mixed Streptococcus pneumoniae and gram-negative bacillary pneumonia in the elderly. South Med J 1981;74:144-146.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1982.00340220056012
Publisher site
See Article on Publisher Site

Abstract

Abstract • Group B streptococcal infections, although well studied in neonates, have only recently been appreciated as important infectious agents in adults. Seven cases of Group B streptococcal pneumonia were verified by transtracheal aspiration, blood and sputum cultures, or multiple stab cultures at autopsy. The infections were largely nosocomial and, ultimately, fatal in all seven patients. Our patients were older (average age, 73 years) and much more debilitated than the 13 cases reported in the literature. Diabetes was less common than previously reported. Previous antibiotic therapy was common. Concomitant isolation of another organism (especially Staphylococcus aureus) occurred in five patients. The morphologic findings at autopsy, in one patient, were characterized by a severely necrotizing destructive process. In our experience, Group B streptococcal pneumonia is more common, more devastating, and occurs in an older population than previously reported. (Arch Intern Med 1982;142:1642-1645) References 1. Eickhoff TC, Klein JO, Daly AK, et al: Neonatal sepsis and other infections due to group B streptococci. N Engl J Med 1964;271:1221-1224.Crossref 2. McCracken GH: Group B streptococcal infections. J Pediatr 1976; 89:203-206.Crossref 3. Braunstain J, Tucker FB, Gibson BC: Identification and significance of Streptococcus agalachiae (Lancefield group B). Am J Clin Pathol 1969; 51:207-214. 4. Butter MNW, deMoor CE: Streptococcus agalachiae as a cause of meningitis in the newborn, and of bacteremia in adults: Differentiation of human and animal varieties. J Microbiol Serol 1967;33:439-450. 5. Finland M: Excursion into epidemiology, selected studies during the past four decades at Boston city hospital. J Infect Dis 1973;128:76-124.Crossref 6. Bayer AS, Chow AW, Anthony BF, et al: Serious infections in adults due to group B streptococci. Am J Med 1976;61:498-502.Crossref 7. Lerner PI, Gopalakrishna KV, Wolinsky E, et al: Group B Streptococcus bacteremia in adults: Analysis of 32 cases and review of the literature. Medicine 1977;56:457-573.Crossref 8. Nicklas JM: Serious group B beta-hemolytic streptococcal infections in adults: Report of two cases and a review of the literature. Johns Hopkins Med J 1978;142:39-45. 9. Dworzack DL, Hodges GR, Barnes WG, et al: Group B streptococcal infections in adult males. Am J Med Sci 1979;277:67-73.Crossref 10. Duma RJ, Weinberg AN, Medrek TF, et al: Streptococcal infections: A bacteriologic and clinical study of streptococcal bacteremia. Medicine 1969;48:78-127.Crossref 11. Berk SL, Holtsclaw MC, Khan A, et al: Transtracheal aspiration in the severely ill elderly patient with bacterial pneumonia. J Am Geriatr Soc 1981;29:228-231. 12. Berk SL, Wiener SL, Eisner LB, et al: Mixed Streptococcus pneumoniae and gram-negative bacillary pneumonia in the elderly. South Med J 1981;74:144-146.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Sep 1, 1982

References