A clinical study of beta-haemolytic groups A, B, C and G streptococcal bacteremia in adults over an 8-year period.
All of the 88 episodes of beta-haemolytic streptococcal bacteremia (2.9% of all bacteremias) in adult patients during the years 1987-94 in a university hospital were reviewed. 38 bacteremias (43%) were caused by group A, 24 (27%) by group B, 3 (4%) by group C, and 23 (26%) by group G beta-haemolytic streptococcal. There was a statistically significant increase in group A and decrease in group C and G bacteremias (p < 0.02) compared to an earlier 8-year period in the same hospital, although the total number of streptococcal bacteremias remained the same. The most common T types of group A streptococcal strains were T11 (26%), T28 (14%), T6 and T1 (11% each), and T12 (8%). Cardiovascular disease, skin lesions, malignancy, and alcohol abuse were the most common underlying conditions. The most usual types of infection were skin (47%) and respiratory tract infections (23%). The overall mortality was 16%. It was highest in group A (24%) and lowest in group C (0%), 38% of patients with pneumonia died. All streptococcal strains were sensitive to penicillin, vancomycin, and cephalosporins. 11% of group A and 12% of all the strains had decreased sensitivity to erythromycin, 14 and 38% to tetracycline, and 0 and 2% to clindamycin, respectively.
Schugk
J
J
Department of Medicine, Helsinki University Central Hospital, Finland.
Harjola
V P
VP
Sivonen
A
A
Vuopio-Varkila
J
J
Valtonen
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D016470:Bacteremia / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D015373:Bacterial Typing Techniques; D002318:Cardiovascular Diseases / Q000150:complications; D002981:Clindamycin / Q000494:pharmacology; D004352:Drug Resistance, Microbial; D004917:Erythromycin / Q000494:pharmacology; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications; D012189:Retrospective Studies; D012871:Skin Diseases / Q000150:complications; D013290:Streptococcal Infections / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D013291:Streptococcus / Q000187:drug effects / Q000302:isolation & purification; D013292:Streptococcus agalactiae / Q000187:drug effects / Q000302:isolation & purification; D013297:Streptococcus pyogenes / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification; D013752:Tetracycline / Q000494:pharmacology
D000900:Anti-Bacterial Agents; D002981:Clindamycin; D004917:Erythromycin; D013752:Tetracycline