engleski

145. Liver Steatosis as a Risk Factor for Invasive Group B Streptococcus Infection in Non-Pregnant Adults

Background Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease associated with metabolic syndrome and systemic changes in immune response. However, the impact of NAFLD on bacterial infections is unknown. Group B Streptococcus (GBS) infection is a significant cause of invasive disease among adult non-pregnant patients with high mortality rates, associated with diabetes mellitus and obesity as the most common underlying conditions. The aim of this study was to analyze the association of liver steatosis with invasive GBS disease outcomes. Methods A retrospective, cohort study of all non-pregnant adult patients diagnosed with invasive GBS infection (GBS isolated from the normally sterile site) was conducted at the University Hospital for Infectious Diseases Zagreb during a 14-year period. Results Of the 127 patients with invasive GBS, 90 had complete data and were included in the study. Disease primarily presented as bacteremia without focus (34 ; 37.8%), cellulitis/erysipelas (27 ; 30.0%), pneumonia (11 ; 12.2%) and endocarditis (8 ; 8.9%). The most common co-morbidities were diabetes (36 ; 40.0%), dyslipidemia (35 ; 38.9%), cardiovascular (32 ; 35.6%), peripheral vascular disease (18 ; 20.0%) and malignancy (16 ; 17.8%). Based upon the results of abdominal US the patients were divided into two groups: with steatosis (39 ; 43.3%) and without steatosis (51 ; 56.6%). The patients with liver steatosis were younger (63 ± 13 vs. 71 ± 14 years, P = 0.01), had higher AST (45.0 ; IQR 30–71 vs. 28.5 ; IQR 20–71, P = 0.047) and ALT (38 ; 25.5–55.5 vs. 21.5 ; 14– 40, P = 0.009). There were no differences in clinical presentation and comorbidities between groups. The in-hospital mortality was 43.5% in patients with steatosis (17/39) and 17.6% (9/51) in control group (P = 0.009). Logistic regression analysis showed that endocarditis (OR 200.8 ; 95% CI 11.5–3512.5), primary bacteremia (6.5 ; 1.7– 25.0), qSOFA ≥2 (20.2 ; 4.2–97.6) and liver steatosis (8.4 ; 2.0–35.1) were associated with in-hospital mortality. Conclusion Our findings showed that invasive GBS disease has significant mortality, which is independently associated with liver steatosis.

liver steatosis ; NAFLD ; Group B Streptococcus

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