• Cameron M Wright, Rachael Moorin, John Dyer, Jonathan Carapetis, and Laurens Manning.
• Department of Infectious Diseases, Fiona Stanley Fremantle Hospitals Group, Perth, Western Australia, Australia.
• Intern Med J. 2025 Jan 8.

BackgroundNeonatal and puerperal sepsis are major manifestations of invasive group B streptococcal (Streptococcus agalactiae; iGBS) infections. International data indicate the importance of iGBS infections among non-pregnant adults.AimsTo describe the burden of iGBS infections in Western Australia (WA) between 2000 and 2018 in terms of incidence, length of hospitalisation and all-cause 30- and 90-day mortality.MethodsThis was a retrospective, population-based study using linked data from the state government-owned pathology provider, hospitalisations and death registrations. Children and adults with isolation of GBS in a normally sterile site or a hospital-based diagnosis of iGBS infection were included.ResultsThere were 2861 cases; just over a quarter (n = 768) were aged 0-1 year. Half of the cases were among females (1438 of 2861), and the median age was 39 years. Incidence increased over the study period, with an age- and sex-adjusted incidence rate ratio for year of 1.08 (95% confidence interval (CI) 1.06-1.09). The incidence in 2018 was 9.5 cases (95% CI 8.3-10.6 cases) per 100 000 population. The proportion of cases among those aged 0-1 year fell across the period, while the relative incidence in older age groups increased. The median length of hospital stay was 7 days (interquartile range 4-15 days), and mortality at 30 days was 3% (95 of 2861).ConclusionsiGBS cases increased across the period 2000-2018 in WA, with older adults making up a higher proportion of cases over time. Preventive efforts among older patients, including potentially through vaccination, may reverse this increase.© 2025 The Author(s). Internal Medicine Journal published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Physicians.

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