Population surveillance of invasive GBS infection has identified an increasing incidence of adult disease in many countries. As a means to understand the risk factors for adult disease, we undertook a study to quantify the burden in patients undergoing surgery in England.
Public Health England National surgical site infection (SSI) surveillance data for patients undergoing 18 categories of surgery were extracted and analysed to assess the contribution of GBS to the overall burden of SSI. Data were prospectively collected by hospitals using standardised active surveillance methodology identifying infections within 30 days of surgery (1y for surgery for prosthetic implants). This study was supported by a grant from Pfizer Inc.
Surveillance data on 961,414 patients undergoing surgery between 2008 and 2015 were submitted by 239 participating hospitals. Preliminary findings identified 215 SSIs due to GBS of which 44% were superficial incisional infections, 37% deep incisional and 19% organ/space infections. The median time to onset of GBS infection in surgery with implant was 21 days (IQR 13-48d) and 10 days for surgery without prosthesis (IQR 6-14d). Of the SSIs with microbiological diagnosis (n=11,409), GBS was most common in Caesarean section accounting for 5.41% of SSIs followed by abdominal hysterectomy (4.70%) and hip replacement (2.58%).
Our preliminary findings have highlighted the relative importance of GBS as a cause of post-surgical infection, including in several high volume categories of surgery. Further assessment to assess the proportion potentially preventable should be undertaken.