Extra-abdominal infections due to Gemella species.
OBJECTIVE
To understand the role of Gemella species as a pathogen causing extra-abdominal infections in the Hospital General Universitario Gregorio Marañón.


METHODS
Between 1994 and 1998, one or more isolates of Gemella sp. were found in 128 patients. The 113 patients with isolates from nonsignificant specimens or representing intra-abdominal infections were excluded. The clinical records of the remaining 15 patients were reviewed as well as the more recent literature.


RESULTS
Mean age of patients was 41 years. The underlying conditions most frequently noted were intravenous drug users (n=6; 3 positive for human immunodeficiency virus), alcoholism (n=2), cardiovascular disease (n=2), chronic lung disease (n=2), diabetes (n=1), kidney transplant (n=1). The extra-abdominal infections were skin and soft tissue abscess (n=5), empyema (n=4), brain abscess (n=2), primary bacteremia (n=1), lung abscess (n=1), septic thrombophlebitis (n=1), complicated urinary tract infection (n=1). The infection was monomicrobial in six and polymicrobial in nine cases. Surgical drainage and betalactam antibiotics were used. The outcome was favorable in almost all cases.


CONCLUSIONS
Gemella sp. should be included as a cause of localized soft-tissue abscesses, empyema, and bloodstream infection. No case of infective endocarditis was found. Although it is susceptible to several antibiotics, Gemella sp. requires a careful microbiologic diagnosis and a subtle clinical interpretation.
García-Lechuz
Juan M
JM
Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain. lechuz@efd.net
Cuevas-Lobato
Oscar
O
Hernángomez
Susana
S
Hermida
Ana
A
Guinea
Jesús
J
Marín
Mercedes
M
Peláez
Teresa
T
Bouza
Emilio
E
D000038:Abscess; D000293:Adolescent; D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000382:microbiology / Q000401:mortality; D001421:Bacteria, Anaerobic / Q000145:classification / Q000302:isolation & purification; D001922:Brain Abscess / Q000382:microbiology; D004653:Empyema / Q000382:microbiology*; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology; D006095:Gram-Positive Cocci / Q000145:classification / Q000302:isolation & purification*; D006801:Humans; D008169:Lung Abscess / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D017192:Skin Diseases, Bacterial / Q000382:microbiology*; D018461:Soft Tissue Infections / Q000382:microbiology*