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Related Experiment Videos

Infections due to Lancefield group C streptococci.

R A Salata1, P I Lerner, D M Shlaes

  • 1Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio.

Medicine
|July 1, 1989
PubMed
Summary

Group C streptococcal infections are an emerging threat, often acquired in hospitals and affecting patients with underlying conditions. Early combination therapy is recommended for severe cases.

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Area of Science:

  • Infectious Diseases
  • Microbiology
  • Clinical Medicine

Background:

  • Group C streptococci (GCS) are increasingly recognized as opportunistic pathogens.
  • Historically, GCS infections were less common, but recent data highlight their growing nosocomial and opportunistic role.

Observation:

  • A 15-year study identified significant risk factors for GCS infection, including chronic cardiopulmonary disease, diabetes, malignancy, and alcoholism in a predominantly male cohort.
  • Bacteremia was prevalent (74%), with nosocomial acquisition in 26% of cases.
  • Infections were often polymicrobial, frequently involving gram-negative enteric bacilli.

Findings:

  • GCS infections presented a wide spectrum, including puerperal sepsis, pleuropulmonary, skin and soft-tissue, CNS, endocarditis, urinary tract, and pharyngeal infections.

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  • Novel syndromes like intra-abdominal abscess, epidural abscess, and dialysis-associated infections were observed.
  • Outcomes correlated with underlying conditions; antibiotic tolerance in GCS requires further investigation.

    • Implications:

    • The study advocates for initial combination therapy with cell-wall-acting agents and an aminoglycoside for severe GCS infections.
    • This approach is particularly recommended for endocarditis, meningitis, septic arthritis, or bacteremia in neutropenic patients.
    • Further research is needed to clarify the clinical significance of antibiotic-tolerant GCS strains.