Fascinoma RoundsFascinoma Rounds Group B streptococcus in ascitic fluidGroup B streptococcus in ascitic fluid

October 26th, 2005Sharmistha Mishra,

Vanessa Allen,And with great thanks to Subash Mohan

Case #3: Group B streptococcus in ascitic fluidCase #3: Group B streptococcus in ascitic fluid

• How common is GBS in peritonitis?• What are the clinical implications of GBS

peritonitis?

Risk FactorsRisk Factors• Cases associated with continuous

ambulatory peritoneal dialysis (CAPD)– Colonization of genital and anal tract– Seven cases have been described previously and all had a

very severe course

Liakopoulos V. et al. Clinical Nephrology. 62(5):391-6, 2004 Nov. Scanziani R. et al. Nephrology Dialysis Transplantation. 14(9):2222-4, 1999 Sep.

Group B Strep InfectionGroup B Strep Infection• Seen in neonates and peripartum women• In non -pregnant adults (2/3rds of cases)

– DM, Liver failure, RF, malignancy, AIDS– Most often manifested as

• skin or soft-tissue infection• bacteremia • genitourinary infection• Pneumonia

• Peritonitis– 5-10% caused by strep spp.– Most common is viridans streptococcus

PathophysiologyPathophysiology• From GU source

– 10- 30% of pregnant women colonized– Peritonitis secondary

• Severity of disease – Secondary bacteremia

Farley MM, et al. N Engl J Med. 1993;328:1807-1811.