Increase in group G streptococcal infections in a community hospital, New York, USA.

摘要: To the Editor: Identified in 1935 by Lancefield and Hare, group G streptococci (GGS) are part of normal flora pharynx, gastrointestinal tract, genital skin (1–3). However, previous case reports have indicated that GGS also could cause complicated infections, including cellulitis, osteomyelitis, septic arthritis, meningitis, endocarditis, bacteremia (3–6). Since mid-1980s, several studies worldwide reported an increasing incidence (1,5–8), but no recent study has been conducted United States to determine overall infection. We noticed number patients with admitted Long Island College Hospital Brooklyn, New York, USA, during past few years. better understand trend infection our institution, we retrospectively reviewed charts from January 2003 through December 2007 who had microbiologically proven infection. Inclusion criteria were clinically documented received appropriate antimicrobial drugs >18 years age. identified laboratory latex agglutination test; resistance profiles not done for GGS. A total 73 persons hospital 5-year period; increased yearly (Figure). Mean age was 53 years; most (77%) <65 age; 52% women, (61%) African American. Thirty (41%) polymicrobial infections; other organisms included methicillin-susceptible Staphylococcus aureus (8 [11%]), methicillin-resistant S. (MRSA) (9 [12%]), gram-negative or anaerobic (13 [18%]). Figure Annual streptococcal infections Hospital, 2003–2007. The spectrum ranged mild soft tissue (34 [46%]) invasive diseases, urogenital (7 [10%]); lower respiratory tract pharyngitis (6 [8%]); endocarditis catheter (5 [7%]); others (14 [19%]), such as peritonitis, pelvic abscess, rectal arthritis. Four 6 assumed be colonized organism. Eight (24%) 34 associated bacteremia, 5 (15%) 20 (59%) infections. Six 1 each infection, dental abscess infections. Eighteen which yearly. Of these, 8 4 2 urinary possible spontaneous bacteria hemodialysis infection; unknown source. vegetations on native valves, a pacemaker prosthetic valve vegetation. One occurred tricuspid injection drug user. Another patient epidural aortic vegetation. Most underlying medical conditions; 34% diabetes mellitus. In contrast reports, stated malignancy common disease (2,3), only 7 (10%) malignancy, whom active rest malignancy. Nine history use HIV identified; secondary both intravenous use. Three (4%) died; their deaths unlikely attributable because all elderly (78–92 years) coexisting conditions co-infections. All survived. Five co-infected MRSA treated vancomycin daptomycin; remainder β-lactam sources (catheter pacemaker) removed. When caused anaerobe identified, they drugs. The average length stay 9.4 days, longer stays those mellitus (14.6 days) than without (6.7 days). GGS important etiologic agent wide Its impressive increase institution raises concerns types β-hemolytic recently. Group A B (9,10) substantially 1980s. multicenter analysis may confirm emerging human pathogen help us reason this increase.