Expanding the definition beyond surveillance criteria reveals a large burden of osteomyelitis caused by group B Streptococcus in the United States Veterans Health Administration

Table 1 Characteristics of patients from the US Veterans Health Administration with diagnosis of GBS osteomyelitis

Characteristics	All (n = 1281)	Definite GBS osteomyelitis (n = 768)	Probable GBS osteomyelitis (n = 513)	P-value^a
Male sex, No. (%)^b	1259 (98%)	756 (98%)	503 (98%)	0.762
Age, mean (± SD)^c	63.2 (± 10.1)	62.8 (± 9.7)	63.7 (± 10.7)	0.127
Race
White	926 (72%)	540 (70%)	386 (75%)	0.087
Black	253 (20%)	158 (21%)	95 (19%)
Other^d	101 (8%)	69 (9%)	32 (6%)
Ethnicity
Non-Latinx	1138 (89%)	673 (88%)	465 (91%)	0.054
Latinx	103 (8%)	73 (10%)	30 (6%)
Other^d	40 (3%)	22 (3%)	18 (4%)
Charlson Comorbidity Index, mean (± SD)^c	4.10 (± 2.3)	3.82 (± 2.3)	4.52 (± 2.4)	< 0.001
Specific medical comorbid conditions
Diabetes mellitus	1120 (87%)	690 (90%)	430 (84%)	0.002
Peripheral vascular disease	468 (37%)	239 (31%)	229 (45%)	< 0.001
Heart disease	394 (31%)	227 (30%)	167 (33%)	0.282
Renal disease	392 (31%)	224 (29%)	168 (33%)	0.193
Pulmonary disease	340 (27%)	163 (21%)	177 (35%)	< 0.001
Stroke	192 (15%)	93 (12%)	99 (19%)	0.001
Cancer	157 (12%)	99 (13%)	58 (11%)	0.447
Liver disease	148 (12%)	68 (9%)	80 (16%)	0.001
AIDS/HIV	10 (1%)	7 (1%)	3 (1%)	0.566
Body mass index (BMI) ≥ 30	651 (51%)	382 (50%)	269 (52%)	0.374
Diabetic with a hemoglobin A1c ≥ 7.5	828 (65%)	554 (72%)	274 (53%)	< 0.001
Polymicrobial cultures^e	779 (61%)	342 (45%)	437 (85%)	< 0.001
Staphylococcus aureus	418 (33%)	169 (22%)	249 (49%)	< 0.001
Pseudomonas aeruginosa	81 (6%)	27 (4%)	54 (11%)	0.005
Other organisms^f	362 (28%)	182 (24%)	180 (35%)	0.607

^aCompares definitive vs. probable osteomyelitis
^bAll values written as No. (%) unless otherwise indicated
^cSD, standard deviation
^dFor Race includes American Indian, Alaska Native, Asian, Native Hawaiian or Pacific Islander and unknown; for Ethnicity includes unknown
^eCases could be included in more than one category, i.e., a microbiology report that included GBS, S. aureus, and any other organisms would be included in the S. aureus as well as the “Other organism” row
^fIncludes potential pathogens, organisms not typically implicated in osteomyelitis (i.e., yeast, coagulase negative Staphylococci spp.), and organisms that cultured and reported without further identification (i.e., Gram-positive cocci or Gram-negative rods)

ISSN: 1471-2334