Group G streptococcal bacteraemia in a community teaching hospital

The group G streptococci are beta-haemolytic streptococci which are characterised by the presence of the Lancefield group G antigen, and have been implicated in a variety of infections. Underlying malignancy has been reported in up to 67% of patients with group G streptococcal bacteraemia in some series. The clinical records of 11 patients with positive blood cultures for group G streptococci over the period from January 1993 to December 1997 were evaluated. Group G streptococci were recovered from only 0.025% (19 out of 77,323 total cultures) of blood cultures during this period. The source of bacteraemia was determined to originate from skin in seven patients (64%). Bacteraemia in the other four patients was probably due to endometritis, septic arthritis, osteomyelitis, and a central venous catheter. All of the patients had an underlying chronic disease or other predisposing factor such as a joint prosthesis or venous catheter. Only one patient in this series had an underlying malignancy, a metastatic pelvic sarcoma. One patient died of multiple organ failure after several days in the hospital. All surviving patients were successfully treated with antibiotics, typically a beta-lactam agent. This study suggests that in the community-hospital setting, skin infection is the most common source of group G streptococcal bacteraemia, typically in patients with underlying chronic disease; however, malignancy appears to be an uncommon predisposing factor.