To the Editor.
—The article "Invasive Group B Streptococcal Disease in Adults" by Schwartz et al1 emphasized the importance and need to define strategies for the prevention of group B streptococcal (GBS) disease in adults. Pregnant patients accounted for 14 (20%) of the 70 cases in adults. The study design used by Schwartz et al would tend to underestimate GBS invasive disease in parturients because intrapartum fever, presumably due to amniotic infection, is sometimes empirically treated without obtaining cultures of blood, amniotic fluid, or urine. These patients would not be identified using their study design, which required a positive culture from a normally sterile site. Parturients colonized with GBS at the time of rupture of membranes or at labor and delivery are at increased risk for endometritis, bacteremia, wound infection, and sepsis compared with noncolonized women. The vaginal infections and prematurity study evaluated 7742 women and determined that 18.6%
Greenspoon JS. Invasive Group B Streptococcal Disease in Adults. JAMA. 1991;266(23):3283-3284. doi:10.1001/jama.1991.03470230041017