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Bacteraemia with Streptococcus agalactiae – an observational study on clinical aspects and time to blood culture positivity

Sunnerhagen, Torgny LU orcid ; Mnajed, Rima ; Törngren, Alfred and Bläckberg, Anna LU (2026) In European Journal of Clinical Microbiology & Infectious Diseases
Abstract
Purpose
Streptococcus agalactiae causes severe infections. Time to blood culture positivity (TTP) has been suggested as a marker of disease severity. This study investigated the clinical characteristics of S. agalactiae bacteraemia and the association between TTP and outcomes.

Methods
This retrospective population-based study included adult episodes of S. agalactiae bacteraemia in southern Sweden, from 2016 to 2023. Medical records were reviewed. Information on TTP was obtained from the Department of Clinical Microbiology in Skåne. The primary outcome was 30-day mortality rate. Secondary outcomes were infective endocarditis (IE), development of sepsis and clinical deterioration within 48 h of blood culture... (More)
Purpose
Streptococcus agalactiae causes severe infections. Time to blood culture positivity (TTP) has been suggested as a marker of disease severity. This study investigated the clinical characteristics of S. agalactiae bacteraemia and the association between TTP and outcomes.

Methods
This retrospective population-based study included adult episodes of S. agalactiae bacteraemia in southern Sweden, from 2016 to 2023. Medical records were reviewed. Information on TTP was obtained from the Department of Clinical Microbiology in Skåne. The primary outcome was 30-day mortality rate. Secondary outcomes were infective endocarditis (IE), development of sepsis and clinical deterioration within 48 h of blood culture collection.

Results
A total of 463 patients were included. Median age was 72 years (interquartile range (IQR 62–82). Skin and soft tissue were the most common focus of infection. IE occurred in 23 patients. 30-day mortality was 9% (n = 40). TTP analysis included 411 patients. There was no statistically significant difference in levels of TTP between patients with 30-day mortality and survivors, 8.6 h (IQR 7.6–10.1) vs. 9.1 h (IQR 7.8–10.4), p = 0.4. Patients with IE had statistically significantly lower levels of TTP compared to patients without IE, 7.5 h (IQR 5.9–8.8) vs. 9.1 h (IQR 7.9–10.5), p = 0.005.

Conclusion
S. agalactiae bacteraemia occurs in elderly patients, predominantly male, with a relatively high mortality. Shorter TTP was associated with the presence of IE, but not with mortality or sepsis, suggesting a potential role in identifying patients at risk for IE in S. agalactiae bacteraemia. (Less)
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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
European Journal of Clinical Microbiology & Infectious Diseases
publisher
Springer Science and Business Media B.V.
external identifiers
  • pmid:41575680
ISSN
0934-9723
DOI
10.1007/s10096-026-05411-w
language
English
LU publication?
yes
id
5c640a24-d285-424e-b772-e4e067b5281d
date added to LUP
2026-01-24 08:28:05
date last changed
2026-01-26 07:22:04
@article{5c640a24-d285-424e-b772-e4e067b5281d,
  abstract     = {{Purpose<br/>Streptococcus agalactiae causes severe infections. Time to blood culture positivity (TTP) has been suggested as a marker of disease severity. This study investigated the clinical characteristics of S. agalactiae bacteraemia and the association between TTP and outcomes.<br/><br/>Methods<br/>This retrospective population-based study included adult episodes of S. agalactiae bacteraemia in southern Sweden, from 2016 to 2023. Medical records were reviewed. Information on TTP was obtained from the Department of Clinical Microbiology in Skåne. The primary outcome was 30-day mortality rate. Secondary outcomes were infective endocarditis (IE), development of sepsis and clinical deterioration within 48 h of blood culture collection.<br/><br/>Results<br/>A total of 463 patients were included. Median age was 72 years (interquartile range (IQR 62–82). Skin and soft tissue were the most common focus of infection. IE occurred in 23 patients. 30-day mortality was 9% (n = 40). TTP analysis included 411 patients. There was no statistically significant difference in levels of TTP between patients with 30-day mortality and survivors, 8.6 h (IQR 7.6–10.1) vs. 9.1 h (IQR 7.8–10.4), p = 0.4. Patients with IE had statistically significantly lower levels of TTP compared to patients without IE, 7.5 h (IQR 5.9–8.8) vs. 9.1 h (IQR 7.9–10.5), p = 0.005.<br/><br/>Conclusion<br/>S. agalactiae bacteraemia occurs in elderly patients, predominantly male, with a relatively high mortality. Shorter TTP was associated with the presence of IE, but not with mortality or sepsis, suggesting a potential role in identifying patients at risk for IE in S. agalactiae bacteraemia.}},
  author       = {{Sunnerhagen, Torgny and Mnajed, Rima and Törngren, Alfred and Bläckberg, Anna}},
  issn         = {{0934-9723}},
  language     = {{eng}},
  month        = {{01}},
  publisher    = {{Springer Science and Business Media B.V.}},
  series       = {{European Journal of Clinical Microbiology & Infectious Diseases}},
  title        = {{Bacteraemia with Streptococcus agalactiae – an observational study on clinical aspects and time to blood culture positivity}},
  url          = {{https://lup.lub.lu.se/search/files/240428408/s10096-026-05411-w.pdf}},
  doi          = {{10.1007/s10096-026-05411-w}},
  year         = {{2026}},
}