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Journal of Clinical Microbiology, July 2009, p. 2055-2060, Vol. 47, No. 7
0095-1137/09/$08.00+0 doi:10.1128/JCM.00154-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.
Diversity of Group B Streptococcus Serotypes Causing Urinary Tract Infection in Adults
Kimberly B. Ulett,1,
William H. Benjamin Jr.,2,3,
Fenglin Zhuo,4
Meng Xiao,4
Fanrong Kong,4
Gwendolyn L. Gilbert,4
Mark A. Schembri,5 and
Glen C. Ulett2,6*
Departments of Medicine,1 Microbiology,2 Pathology, University of Alabama at Birmingham, Birmingham, Alabama 35294,3 Centre for Infectious Diseases and Microbiology, Institute of Clinical Pathology and Medical Research, Westmead, 2145 New South Wales, Australia,4 School of Chemistry and Molecular Biosciences, University of Queensland, Brisbane, 4072 Queensland, Australia,5 School of Medical Sciences, Centre for Medicine and Oral Health, Griffith University Gold Coast Campus, 4222 Queensland, Australia6
Received 24 January 2009/ Returned for modification 2 April 2009/ Accepted 7 May 2009
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 1-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 blotting (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 of >107 CFU/liter and at least one UTI symptom; of these patients, 31 had urinary leukocyte esterase and pyuria (others not tested), 50 (81%) had symptoms consistent with cystitis, and 12 (19%) had symptoms 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; and 45/56 (80.4%) isolates with discrepant results were typed by mPCR/RLB as belonging to serotype V. Serotypes V, Ia, and III caused the most UTIs; serotypes 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 causes UTI than previously recognized, with the exception of nontypeable GBS.
* Corresponding author. Mailing address: Department of Microbiology, University of Alabama at Birmingham, 845 19th Street South, Birmingham, AL 35294-2170. Phone: (205) 996-7695. Fax: (205) 934-0605. E-mail: gulett{at}uab.edu
Published ahead of print on 13 May 2009.
K.B.U. and W.H.B. contributed equally.
Journal of Clinical Microbiology, July 2009, p. 2055-2060, Vol. 47, No. 7
0095-1137/09/$08.00+0 doi:10.1128/JCM.00154-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.
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