A Group G Streptococcal Bacteremia Case Series and Comparison of Community and Nosocomial Infections

The Clinical features of group G streptococcus (GGS) bacteremia have been reported, but the differences in the clinical features between the community-acquired group and the nosocomial group have not been discussed in detail. The objective of our study was to retrospectively examine the clinical features of GGS bacteremia in our hospital and elucidate the differences in the clinical features between the community-acquired group and the nosocomial group. We included all patients with GGS-positive blood cultures who had been treated between June 2005 and September 2014 at the Kameda Medical Center, a 900- bed teaching hospital in Japan. We collected demographic and clinical data and analyzed differences between the community-acquired group and the nosocomial group. During the study period, 104 episodes of GGS bacteremia were recorded, with 92 episodes for the community-acquired group and 12 for the nosocomial group. The median age was 81 years (range, 18-97 years) and underlying diseases were present in 84.6% of the patients. Cellulitis was the most common diagnosis (52.9%) followed by primary bacteremia (14.4%). In the nosocomial group, a lesser tendency of skin and soft tissue infections was noted (OR 0.05, 95% CI 0.01-0.27, p＜0.01) with a greater tendency seen of bacteremia without focus (OR 16.4, 95% CI 4.38-61.2, p ＜0.01) than in the community-acquired group. In our hospital, GGS bacteremia was observed mainly in elderly patients with underlying medical conditions, involing skin and soft tissue infections being the most common, similar to other reports. High median age and low percentage of primary bacteremia were the unique features. In the nosocomial group, the most frequent clinical diagnosis was primary bacteremia, and the skin and soft tissue infections were less likely.