Group B Streptococcus in surgical site and non-invasive bacterial infections worldwide: A systematic review and meta-analysis

Simon M Collin, Nandini Shetty, Rebecca Guy, Victoria N Nyaga, Ann Bull, Michael J Richards, Tjallie I I van der Kooi, Mayke B G Koek, Mary De Almeida, Sally A Roberts, Theresa Lamagni

Research output: Contribution to journalArticle (Academic Journal)peer-review

11 Citations (Scopus)
130 Downloads (Pure)


OBJECTIVES: The epidemiology of disease caused by group B Streptococcus (GBS; Streptococcus agalactiae) outside pregnancy and the neonatal period is poorly characterized. The aim of this study was to quantify the role of GBS as a cause of surgical site and non-invasive infections at all ages.

METHODS: A systematic review (PROSPERO CRD42017068914) and meta-analysis of GBS as a proportion (%) of bacterial isolates from surgical site infection (SSI), skin/soft tissue infection (SSTI), urinary tract infection (UTI), and respiratory tract infection (RTI) was conducted.

RESULTS: Seventy-four studies and data sources were included, covering 67 countries. In orthopaedic surgery, GBS accounted for 0.37% (95% confidence interval (CI) 0.08-1.68%), 0.87% (95% CI 0.33-2.28%), and 1.46% (95% CI 0.49-4.29%) of superficial, deep, and organ/space SSI, respectively. GBS played a more significant role as a cause of post-caesarean section SSI, detected in 2.92% (95% CI 1.51-5.55%), 1.93% (95% CI 0.97-3.81%), and 9.69% (95% CI 6.72-13.8%) of superficial, deep, and organ/space SSI. Of the SSTI isolates, 1.89% (95% CI 1.16-3.05%) were GBS. The prevalence of GBS in community and hospital UTI isolates was 1.61% (1.13-2.30%) and 0.73% (0.43-1.23%), respectively. GBS was uncommonly associated with RTI, accounting for 0.35% (95% CI 0.19-0.63%) of community and 0.27% (95% CI 0.15-0.48%) of hospital RTI isolates.

CONCLUSIONS: GBS is implicated in a small proportion of surgical site and non-invasive infections, but a substantial proportion of invasive SSI post-caesarean section.

Original languageEnglish
Pages (from-to)116-129
Number of pages14
JournalInternational Journal of Infectious Diseases
Early online date24 Apr 2019
Publication statusPublished - 1 Jun 2019


  • Streptococcus agalactiae
  • Surgical site infection
  • Urinary tract infection
  • Respiratory tract infection
  • Skin and soft tissue infection


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