Group B streptococcus infections of soft tissue and bone in California adults, 1995-2012

E. M. Smith, M. A. Khan, A. Reingold, J. P. Watt

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Group B streptococcus (GBS) is an increasing cause of disease in adults. We present long-term trends in incidence of overall infections and identify characteristics of patients with GBS cellulitis, bone and joint infections. Active, population-based surveillance was conducted from 1995-2012 in three California counties and the data were analysed retrospectively. All cases had isolation of GBS from a normally sterile site. Cases of cellulitis were classified based on clinical diagnosis. GBS bone or joint infection was defined as isolation of GBS from a bone or joint or a diagnosis of osteomyelitis or septic arthritis. Medical charts were reviewed for demographic and clinical information. There were 3917 cases of GBS; the incidence of disease increased from 5·8 to 8·3 cases/100 000 persons (P <0·001) from 1995 to 2012. In adults aged ≥40 years, the overall incidence of GBS increased from 8·5 to 14·2 cases/100 000 (P <0·001) persons during the study period. The incidence of cellulitis increased from 1·6 to 3·8 cases/100 000 (P <0·001), bone infection increased from 0·7 to 2·6 cases/100 000 (P <0·001), and the incidence of joint infection remained approximately constant at an average rate of 1·0 case/100 000. The highest incidence rates were observed in men, persons aged ≥80 years, non-Hispanic blacks and Hispanics. Diabetes was the most common underlying condition (51·2% cellulitis cases, 76·3% bone infections, 29·8% joint infections).

Original languageEnglish (US)
Pages (from-to)3343-3350
Number of pages8
JournalEpidemiology and Infection
Issue number15
StatePublished - Nov 1 2015
Externally publishedYes


  • Bone infections
  • epidemiology
  • joint infection
  • skin infections
  • streptococcal infections

ASJC Scopus subject areas

  • Infectious Diseases
  • Epidemiology
  • Medicine(all)


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