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Invasive group G streptococcal infections: a review of 37 cases
1Department of Medicine, Veterans General Hospital-Taipei, Taiwan, R.O.C.
Background:
Beta-hemolytic streptococci group A, B, and D which cause many diseases have been well studied. Infection caused by group G Streptococcus has increased in clinical significance, and thus is attracting more physicians attention. This retrospective analysis reports clinical experience with such infections at the Veterans General Hospital-Taipei.
Methods:
Medical records of invasive group G streptococcal isolates from March 1991 to April 1994 were reviewed. Thirty-seven cases were included.
Results:
There were 33 males and 4 females with a mean age of 67.4. Major underlying diseases included diabetes (24.3%), cardiovascular diseases (21.6%), malignancy (21.6%), bone or joint diseases (18.9%) and cirrhosis of the liver (13.5%). Only 8.1% cases had no underlying disease. The most common portal of entry was the skin (64.9%). There was a wide spectrum of clinical manifestations, including cellulitis (32.4%), arthritis or osteomyelitis (16.2%), endocarditis (8.1%), meningitis (8.1%), peritonitis (8.1%), empyema (5.4%) and primary bacteremia (27%). All of these isolates were susceptible to penicillin, oxacillin, cefazolin, clindamycin and vancomycin. Ten patients died, and five of these expired from group G streptococcal infections.
Conclusions:
Group G Streptococcus is a low virulent microorganism. Clinical improvement after therapy is fast. Poor response to antibiotics should prompt investigation of the underlying diseases or undrained foci of infection.
Insights
Group G Streptococcus infections are increasingly recognized. While generally low virulent, prompt investigation of underlying conditions is crucial for effective treatment and improved patient outcomes.
Area of Science:
- Microbiology
- Infectious Diseases
- Clinical Medicine
Background:
- Group G Streptococcus infections are gaining clinical significance.
- Previous research has focused on other beta-hemolytic streptococci groups (A, B, D).
- This study examines clinical experiences with group G Streptococcus at a specific hospital.
Purpose of the Study:
- To report clinical experiences with invasive group G streptococcal infections.
- To analyze patient demographics, underlying conditions, and clinical manifestations.
- To assess treatment outcomes and antibiotic susceptibility.
Main Methods:
- Retrospective analysis of medical records.
- Inclusion of invasive group G streptococcal isolates from March 1991 to April 1994.
- Review of 37 cases.
Main Results:
- The majority of patients were elderly males with significant underlying diseases (diabetes, cardiovascular disease, malignancy).
- The skin was the most common portal of entry, with diverse clinical presentations including cellulitis, arthritis, and bacteremia.
- All isolates were susceptible to common antibiotics; mortality was observed, with some deaths attributed to group G Streptococcus.
Conclusions:
- Group G Streptococcus is considered a low-virulence pathogen with rapid clinical improvement post-therapy.
- Treatment response is often linked to the management of underlying diseases or infection foci.
- Further investigation is warranted for cases with poor antibiotic response.