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Streptococcus milleri and surgical sepsis.
Annals of the Royal College of Surgeons of England
|March 1, 1983
Summary
Viridans streptococci, including Streptococcus milleri, are increasingly recognized as pathogens in surgical patients. Prophylactic antibiotics may contribute to their emergence, necessitating long-term therapy for associated abscesses.
Area of Science:
- Microbiology
- Infectious Diseases
- Surgical Infections
Background:
- Viridans streptococci traditionally viewed as commensals, except in endocarditis.
- Emerging evidence suggests Streptococcus milleri as a significant pathogen, causing severe sepsis.
Purpose of the Study:
- To review the clinical experience with Streptococcus milleri in general surgical patients.
- To investigate potential factors contributing to the emergence of Streptococcus milleri as a pathogen.
Main Methods:
- Retrospective review of 23 general surgical patients over a 3-year period.
- Analysis of cases involving Streptococcus milleri infections.
Main Results:
- Streptococcus milleri identified as a cause of life-threatening sepsis in surgical patients.
- Postulation that prophylactic antibiotic combinations (e.g., gentamicin, metronidazole) in colorectal surgery may promote its emergence.
Conclusions:
- Streptococcus milleri is an emerging pathogen in surgical settings.
- Long-term antibiotic therapy is recommended for established sepsis and abscesses caused by Streptococcus milleri.
- Prophylactic antibiotic strategies in colorectal surgery warrant further investigation regarding their role in pathogen emergence.