Obesity, diabetes, and the risk of invasive group B Streptococcal disease in nonpregnant adults in the United States

Samantha I. Pitts, Nisa M. Maruthur, Gayle E. Langley, Tracy Pondo, Kathleen A. Shutt, Rosemary Hollick, Stephanie J. Schrag, Ann Thomas, Megin Nichols, Monica Farley, James P. Watt, Lisa Miller, William Schaffner, Corinne Holtzman, Lee H. Harrison

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Background. Rates of invasive group B Streptococcus (GBS) disease, obesity, and diabetes have increased in US adults. We hypothesized that obesity would be independently associated with an increased risk of invasive GBS disease. Methods. We identified adults with invasive GBS disease within Active Bacterial Core surveillance during 2010-2012 and used population estimates from the Behavioral Risk Factor Surveillance System to calculate invasive GBS incidence rates. We estimated relative risks (RRs) of invasive GBS using Poisson analysis with offset denominators, with obesity categorized as class I/II (body mass index [BMI] = 30-39.9 kg/m2) and class III (BMI ≥ 40.0 kg/m2). Results. In multivariable analysis of 4281 cases, the adjusted RRs of invasive GBS disease were increased for obesity (class I/ II: RR, 1.52; 95% confidence interval [CI], 1.14-2.02; and class III: RR, 4.87; 95% CI, 3.50-6.77; reference overweight) and diabetes (RR, 6.04; 95% CI, 4.77-7.65). The adjusted RR associated with class III obesity was 3-fold among persons with diabetes (95% CI, 1.38-6.61) and nearly 9-fold among persons without diabetes (95% CI, 6.41-12.46), compared with overweight. The adjusted RRs associated with diabetes varied by age and BMI, with the highest RR in young populations without obesity. Population attributable risks of invasive GBS disease were 27.2% for obesity and 40.1% for diabetes. Conclusions. Obesity and diabetes were associated with substantially increased risk of infection from invasive GBS. Given the population attributable risks of obesity and diabetes, interventions that reduce the prevalence of these conditions would likely reduce the burden of invasive GBS infection.

Original languageEnglish (US)
Article numberofy030
JournalOpen Forum Infectious Diseases
Issue number6
StatePublished - Jun 1 2018


  • Behavioral risk factor surveillance system
  • Diabetes
  • Epidemiology
  • Obesity
  • Streptococcal infections

ASJC Scopus subject areas

  • Oncology
  • Infectious Diseases


Dive into the research topics of 'Obesity, diabetes, and the risk of invasive group B Streptococcal disease in nonpregnant adults in the United States'. Together they form a unique fingerprint.

Cite this