BACTEREMIA INVOLVING THE STREPTOCOCCUS-MILLERI GROUP - ANALYSIS OF 19CASES

During a 3-year study period, 19 patients at the University Hospital o f Maastricht developed bloodstream infections with species ofthe ''Str eptococcus milleri'' group, for an incidence of 0.33 per 1,000 admissi ons. The patients' median age was 48 years; the male-to-female ratio w as 2.8. Eleven patients (57.9%) had underlying diseases, among which m alignancy was predominant. Local trauma to the mucosal barrier was an important risk factor. An associated site of infection was found most frequently in the abdominal and thoracic cavities (nine and five cases , respectively). Bacteremia was polymicrobial in four of 19 episodes. The 20 infecting S. milleri strains were identified to the species lev el; Streptococcus anginosus was the most prevalent (16 strains). Eight strains carried Lancefield group C. The isolates were sensitive to mo st antibiotics. Abscess formation was documented in nine cases (47.3%) ; repeated drainage procedures were required in half of these episodes . Mortality was high (five of 19 patients, or 26.3%).