Skip to main content
SpringerLink
Log in

Prospective study ofStreptococcus milleri bacteremia

  • Article
  • Published:
European Journal of Clinical Microbiology and Infectious Diseases Aims and scope Submit manuscript

Abstract

In a prospective study of bacteremia caused by organisms of theStreptococcus milleri group a total of 32 adult patients were observed over a seven-year period. These patients accounted for 1.6% of all patients diagnosed as having significant bacteremia and 17% of all cases of streptococcal (nonpneumococcal) bacteremia diagnosed during the study period. Only five patients had polymicrobic bacteremia. In 31 cases, a presumed origin of infection was identified, generally oral or gastrointestinal disease. There were only six cases of nosocomial acquisition. The most common presenting symptom was prolonged fever. The following forms of presentation were documented: bacteremia with local suppurative infection (56%), bacteremia without local suppurative infection (25%), and endocarditis (19%). An associated focus of infection was found in the abdominal cavity in 20 cases (62%). The mortality rate was 12.5%. All isolates were susceptible to penicillin. Caution is necessary in interpreting a blood culture positive forStreptococcus milleri group organisms, since, unlike other viridans streptococci, they are rarely contaminants. For this reason patients with suppurative processes and/or digestive tract disease must be carefully investigated.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Sussman Jl, Baron EJ, Tenebaun MJ, Kaplan M, Greenspan J, Facklam R, Tyburski M, Goldman M, Kanzer B: Viridans streptococcal endocarditis: clinical, microbiological and echocardiographic correlations. Journal of Infectious Diseases 1986, 154: 597–603.

    Google Scholar 

  2. Facklam RR: Physiological differentiation of viridans streptococci. Journal of Clinical Microbiology 1977, 5: 184–201.

    Google Scholar 

  3. Parker MT, Ball LC: Streptococci and aerococci associated with systemic infection in man. Journal of Medical Microbiology 1976, 9: 275–302.

    Google Scholar 

  4. Murray H, Gross K, Masur H, Roberts R: Serious infections caused byStreptococcus milleri. American Journal of Medicine 1978, 64: 759–764.

    Google Scholar 

  5. Poole A, Wilson G: Occurrence and cultural features ofStreptococcus milleri in various body sites. Journal of Clinical Pathology 1979, 32: 764–768.

    Google Scholar 

  6. Facklam RR: The major differences in the American and BritishStreptococcus taxonomy schemes with special reference toStreptococcus milleri. European Journal of Clinical Microbiology & Infectious Diseases 1984, 3: 91–93.

    Google Scholar 

  7. Colman G, Williams RE: Taxonomy of some human viridans streptococci. In: Wannamaker LW, Matsen JM (ed): Streptococci and streptococcal diseases: recognition, understanding and management. Academic Press, New York, 1972, p. 281–299.

    Google Scholar 

  8. Gossling J: Occurrence and pathogenicity of theStreptococcus milleri group. Reviews of Infectious Diseases 1988, 10: 257–285.

    Google Scholar 

  9. Coykendall AL, Wesbecher PM, Gustafson KB: “Streptococcus milleri”,Streptococcus constallatus, andStreptococcus intermedius are later synonyms ofStreptococcus anginosus. International Journal of Systematic Bacteriology 1987, 37: 222–228.

    Google Scholar 

  10. Stratton C:Streptococcus intermedius group. In: Mandell GL, Bennett JE, Dolin R (ed): Principles and practice of infectious diseases. Churchill Livingstone, New York, 1995, p. 1861–1864.

    Google Scholar 

  11. Whiley RA, Hardie JM: DNA-DNA hybridization studies and phenotypic characteristics of strains within the “Streptococcus milleri group”. Journal of General Microbiology 1989, 135: 2623–2633.

    Google Scholar 

  12. Whiley RA, Beighton D: Emended descriptions and recognition ofStreptococcus constellatus, Streptococcus intermedius, andStreptococcus anginosus as distinct species. International Journal of Systematic Bacteriology 1991, 41: 1–5.

    Google Scholar 

  13. Van der Auwera P: Clinical significance ofStreptococcus milleri. European Journal of Clinical Microbiology & Infectious Diseases 1985, 4: 386–390.

    Google Scholar 

  14. Molina JM, Leport C, Bure A, Wolff M, Michon C, Vilde JL: Clinical and bacterial features of infections caused byStreptococcus milleri. Scandinavian Journal of Infectious Diseases 1991, 23: 659–666.

    Google Scholar 

  15. Piscitelli SC, Shwed J, Schreckenberger P, Danzinger LH:Streptococcus milleri group: renewed interest in an elusive pathogen. European Journal of Clinical Microbiology & Infectious Diseases 1992, 11: 491–498.

    Google Scholar 

  16. Shlaes DM, Lerner PI, Wolinsky E, Gopalakrishna V: Infections due to Lancefield group F and related streptococci (Streptococcus milleri, Streptococcus anginosus). Medicine 1981, 60: 197–207.

    Google Scholar 

  17. Libertin CR, Hermans PE, Washington JA II: Beta-hemolytic group F streptococcal bacteremia. A study and review of the literature. Reviews of Infectious Diseases 1985, 7: 498–503.

    Google Scholar 

  18. Ruiz MP, Soriano F: Significado clinico de la bacteriemia por estreptococos del grupo viridans. Enfermedades Infecciosas y Microbiologia Clinica 1994, 12: 426–432.

    Google Scholar 

  19. Jacobs J, Pietersen H, Stobberingh E, Soeters P: Bacteremia involving the “Streptococcus milleri” group: analysis of 19 cases. Clinical Infectious Diseases 1994, 19: 704–713.

    Google Scholar 

  20. Bauer AW, Kirby WM, Sherris JC, Furck M: Antibiotic susceptibility testing by standardized single disc method. American Journal of Clinical Pathology 1966, 45: 493–496.

    Google Scholar 

  21. Von Reyn CF, Levy BS, Arbeit RD, Friedland G, Crumpacker CS: Infective endocarditis: an analysis based on strict case definitions. Annals of Internal Medicine 1981, 94: 505–518.

    Google Scholar 

  22. Barnhan M: Invasive streptococcal infections in the era before the acquired immune deficiency syndrome: a 10 year compilation of patients with streptococcal bacteraemia in North Yorkshire. Journal of Infection 1989, 18: 231–248.

    Google Scholar 

  23. Duma R, Weinberg A, Medrek T, Kunn L: Streptococcal infections. Medicine 1969, 48: 87–127.

    Google Scholar 

  24. Horstmeier C, Washington JA: Microbiological study of streptococcal bacteremia. Applied Microbiology 1973, 26: 589–591.

    Google Scholar 

  25. Swenson FJ, Rubin SJ: Clinical significance of viridans streptococci isolated from blood cultures. Journal of Clinical Microbiology 1982, 15: 275–279.

    Google Scholar 

  26. Brennan R, Durack D: The viridans streptococci in perspective. In: Remington JS, Swartz MN (ed): Current clinical topics in infectious diseases. McGraw Hill, New York, 1984, p. 253–289.

    Google Scholar 

  27. Moore-Gillon JC, Eykyn S, Phillips I: Microbiology of pyogenic liver abscess. British Medical Journal 1981, 283: 819–820.

    Google Scholar 

  28. Bateman S, Eykyn S, Phillips I: Pyogenic liver abscess caused byStreptococcus milleri. Lancet 1975, ii: 657–659.

    Google Scholar 

  29. Louvois J, Gortval P, Hurley R: Bacteriology of abscesses of the central nervous system: a multicentre prospective study. British Medical Journal 1977, 2: 981–986.

    Google Scholar 

  30. Chun C, Johnson J, Hofsteller M, Raff M: Brain abscess. A study of 45 consecutive cases. Medicine 1986, 65: 415–428.

    Google Scholar 

  31. Brook MG, Lucas RE, Pain AK: Clinical features and management of two cases ofStreptococcus milleri chest infection. Scandinavian Journal of Infectious Diseases 1988, 20: 345–346.

    Google Scholar 

  32. Feigenbaum JA, Stein WE: Infections of the cervical disc space after dental extractions. Journal of Neurology, Neurosurgery and Psychiatry 1974, 37: 1361–1365.

    Google Scholar 

  33. Whiley RA, Beighton D, Winstanley TG, Fraser HY, Hardie JM:Streptococcus intermedius, Streptococcus constellatus, andStreptococcus anginosus (theStreptococcus milleri group): association with different body sites and clinical infections. Journal of Clinical Microbiology 1992, 30: 243–244.

    Google Scholar 

  34. Rich MW, Radwany SM: “Streptococcus milleri” septicemia in a patient with colorectal carcinoma. European Journal of Clinical Microbiology & Infectious Diseases 1993, 12: 225.

    Google Scholar 

  35. Bourgault A, Wilson WR, Washington JA: Antimicrobial susceptibilities of species of viridans streptococci. Journal of Infectious Diseases 1979, 140: 316–321.

    Google Scholar 

  36. Levin RM, Pulliam L, Mondry C, Levy D, Hadley K, Grossman M: Penicillin resistantStreptococcus constellatus as a cause of endocarditis. American Journal of Diseases of Children 1982, 136: 42–45.

    Google Scholar 

  37. Pullian L, Hadley WK: Resistance of viridans streptococci to penicillin. New England Journal of Medicine 1979, 300: 1442–1446.

    Google Scholar 

  38. Potgieter E, Carmichael M, Kornhof HJ, Chalkley LJ: In vitro antimicrobial susceptibility of viridans streptococci isolated from blood cultures. European Journal of Clinical Microbiology & Infectious Diseases 1992, 11: 543–546.

    Google Scholar 

  39. Tresadern JC, Farrand RJ, Irving MH:Streptococcus milleri and surgical sepsis. Annals of the Royal College of Surgeons of England 1983, 65: 78–79.

    Google Scholar 

  40. Onderdonk AB, Cisneros R: Comparison of clindamycin and metronidazole for the treatment of experimental intra-abdominal sepsis produced byBacteroides fragilis andStreptococcus intermedius. Current Therapeutic Research 1985, 38: 893–898.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Hospital Xeral, Lugo, Spain

    E. Casariego, J. C. Corredoira, M. Bal, M. J. López & J. Varela

  2. Department of Microbiology, Hospital Xeral, Lugo, Spain

    A. Rodriguez, P. Alonso & A. Coira

Authors
  1. E. Casariego
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Rodriguez
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. C. Corredoira
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. P. Alonso
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A. Coira
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M. Bal
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M. J. López
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. J. Varela
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Casariego, E., Rodriguez, A., Corredoira, J.C. et al. Prospective study ofStreptococcus milleri bacteremia. Eur. J. Clin. Microbiol. Infect. Dis. 15, 194–200 (1996). https://doi.org/10.1007/BF01591353

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01591353

Keywords

Search

Navigation