Streptococcus suis infection: a series of 41 cases from Chiang Mai University Hospital.
OBJECTIVE
The objectives of this study were (1) to assess the clinical manifestations, treatment, and outcome of Streptococcus suis infection in adult patients in northern Thailand, (2) to evaluate the anti-microbial sensitivity pattern and (3) to determine the predicting factors of high mortality rate.


METHODS
A retrospective study was conducted at Chiang Mai University Hospital from May 2000 to December 2002. Anti-microbial susceptibility test was performed by agar disk diffusion and the minimal inhibitory concentration (MIC) by E-test.


RESULTS
Forty-one patients (32 men and nine women, mean age 51 years) with S. suis infection were identified. Three patients had a history of exposure to pig or pork and one patient had a history of raw beef consumption. Clinical manifestations included infective endocarditis, meningitis, sepsis, spondylodiscitis, and endophthalmitis in 16, 13, 10, 1, and 1 patients, respectively. The overall mortality rate was 19.5%. On univariate analysis, low serum albumin, high serum total bilirubin, low platelet, and rapid onset of illness were significantly correlated with high mortality rate. All isolates were sensitive to penicillin (mean MIC90=0.027 microg/ml).


CONCLUSIONS
S. suis infection is not uncommon in northern Thailand. High suspicion and early detection are important and could lead to the successful treatment.
Wangkaew
Suparaporn
S
Department of Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
Chaiwarith
Romanee
R
Tharavichitkul
Prasit
P
Supparatpinyo
Khuanchai
K
D000328:Adult; D000368:Aged; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004697:Endocarditis, Bacterial / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000188:drug therapy / Q000209:etiology*; D008826:Microbial Sensitivity Tests / Q000379:methods; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000188:drug therapy / Q000209:etiology*; D013290:Streptococcal Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D017011:Streptococcus suis / Q000187:drug effects / Q000472:pathogenicity*; D013552:Swine; D013785:Thailand / Q000453:epidemiology; D013997:Time Factors; D015047:Zoonoses / Q000453:epidemiology / Q000382:microbiology
D000900:Anti-Bacterial Agents