A CLINICAL-STUDY OF BETA-HEMOLYTIC GROUP-A, GROUP-B, GROUP-C AND GROUP-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 b y group A, 24 (27%) by group B, 3 (4%) by group C, and 23 (26%) by gro up G beta-haemolytic streptococci. There was a statistically significa nt 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, altho ugh the total number of streptococcal bacteremias remained the same. T he most common T types of group A streptococcal strains mere T11 (26%) , T28 (14%), T6 and T1 (11% each), and T12 (8%). Cardiovascular diseas e, skin lesions, malignancy, and alcohol abuse were the most common un derlying conditions. The most usual types of infection mere skin (47%) and respiratory tract infections (23%). The overall mortality mas 16% . It was highest in group A (24%) and lowest in group C (0%). 38% of p atients 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 3 8% to tetracycline, and 0 and 2% to clindamycin, respectively.