Streptococcus agalactiae in adults at Chiang Mai University Hospital: a retrospective study.

BACKGROUND: Infection caused by Streptococcus agalactiae, a Group B streptococcus, is an emerging disease in non-pregnant adults. This study describes the epidemiological, clinical, and microbiological characteristics of S. agalactiae infection in adult patients in northern Thailand. METHODS: A retrospective study was conducted between January 1, 2006 and December 31, 2009 at Chiang Mai University Hospital among patients aged ≥15 years, whose clinical specimens obtained from normally sterile sites grew S. agalactiae. RESULTS: One-hundred and eighty-six patients and 197 specimens were identified during the 4-year period. Among 186 patients, 82 were documented as having invasive infection; 42 patients were male (51.2%) with the mean age of 48.5 ± 19.4 years (range 17, 83). Fifty-three patients (64.6%) had underlying medical conditions; 17 patients (20.7%), 10 (12.2%), 8 (9.7%) had diabetes, chronic renal diseases, and malignancy, respectively. Among 40 patients (48.8%) with bloodstream infection, no other site of infection was determined in 29 (35.4%) patients. In the remaining 11 patients, 5 patients (6.1%), 5 (6.1%), and 1 (1.2%) had meningitis, arthritis, and meningitis with arthritis, respectively. Forty-two patients (51.2%) presented with localized infection, i.e., subcutaneous abscess (19 patients, 23.2%), chorioamnionitis (10 patients, 12.2%), urinary tract infection (5 patients, 6.1%), arthritis (3 patients, 3.7%), meningitis (2 patients, 2.4%), and spontaneous bacterial peritonitis, uveitis, and tracheobronchitis (1 patient each, 1.2%). The overall mortality was 14.6% (12 patients). CONCLUSIONS: S. agalactiae infection is a growing problem in non-pregnant patients, particularly in those with underlying medical conditions. Physicians should add S. agalactiae infection in the list of differential diagnoses in patients with meningitis and/or septicemia.

Comparison between Musca domestica and Chrysomya megacephala as carriers of bacteria in northern Thailand.

A comparison between the common house fly, Musca domestica, and the Oriental latrine fly, Chrysomya megacephala, was assessed for their potential as carriers of bacteria in urban areas of Chiang Mai Province, northern Thailand. C. megacephala was significantly more likely to carry bacterial species than M. domestica; however, no significant difference was found between the number of positive male and female flies within the same species. A total of 42 bacterial species were isolated. The most common bacterium isolated from M. domestica was coagulase-negative staphylococci (n=57) followed by Escherichia coli (n=10) and Viridans streptococci (n=10), while that of C. megacephala was non-fermentative gram-negative bacilli (n=59) followed by coagulase-negative staphylococci (n=54).