| Title | Diversity of Group B Streptococcus Serotypes Causing Urinary Tract Infection in Adults. | | Author(s) | Ulett KB, Benjamin WH, Zhuo F, Xiao M, Kong F, Gilbert GL, Schembri MA, Ulett GC | | Institution | Departments of Medicine, Microbiology, and Pathology, University of Alabama at Birmingham, Birmingham AL 35294; Centre for Infectious Diseases and Microbiology, Institute of Clinical Pathology and Medical Research, Westmead, NSW, Australia 2145; School of Chemistry and Molecular Biosciences, University of Queensland, Brisbane QLD, Australia 4072; School of Medical Sciences, Centre for Medicine and Oral Health, Griffith University Gold Coast Campus, QLD, Australia 4222. | | Source | J Clin Microbiol 2009 May 13. | | Abstract | Serotypes of group B streptococcus (GBS) that cause urinary tract infection (UTI) are poorly characterized. We conducted a prospective study of GBS UTI in adults to define the clinical and microbiological characteristics of these infections including which serotypes cause disease. Patients who had GBS cultured from urine over a one year period were grouped according to symptoms, bacteriuria, and urinalysis. Demographic data were obtained by reviewing medical records. Isolates were serotyped by latex agglutination and multiplex PCR-reverse line blot (mPCR/RLB). Antibiotic susceptibilities were determined by disc-diffusion. GBS was cultured from 387/34,367 consecutive urine samples (1.1%); 62 patients had bacteriuria >10(7) cfu/L and >/=1 UTI symptom; of these 31 had urinary leukocyte esterase and pyuria (others not tested), 50 (81%) had symptoms consistent with cystitis and 12 (19%) of pyelonephritis. Compared with controls (who had GBS isolated without symptoms) a prior history of UTI was an independent risk factor for disease. Increased age was also significantly associated with acute infection. Serotyping results were consistent between latex agglutination and mPCR/RLB for 331/387 (85.5%) isolates; 22 (5.7%) and 7 (1.8%) isolates were nontypeable with antisera and by mPCR/RLB, respectively; 45/56 (80.4%) isolates with discrepant results were typed by mPCR/RLB as serotype V. Serotypes V, Ia, and III caused most UTI; II, Ib, and IV were less common. Nontypeable GBS was not associated with UTI. Erythromycin (39.5%) and clindamycin (26.4%) resistance was common. We conclude that a more diverse spectrum of GBS serotypes than previously recognized causes UTI with the exception of nontypeable GBS. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19439533 |
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