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An analysis of Group D streptococci recovered from cancer patients

Analyse der aus Krebspatienten isolierten Streptokokken der Gruppe D

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Summary

A total of 4,166 (17.4%) strains of Group D streptococci were recovered from 27,474 surveillance samples taken from the nose, throat, gingiva, axilla, and rectum of patients at a cancer center. An additional 2,217 strains were recovered from 7,106 urine samples and 58 strains from 5,286 blood samples. Approximately 11% of gingival cultures yielded Group D streptococci.Streptococcus faecalis was most prevalent, followed byStreptococcus bovis, Streptococcus faecium, Streptococcus avium, Streptococcus equinus, andStreptococcus durans. Six of the 11 premortem blood cultures positive forS. faecalis grew other organisms as well, chiefly gram negative bacilli. The sevenS. faecalis recovered from postmortem bloods all occurred together with gram-negative bacilli or yeasts. Abscesses and lesions had recovery rates of 7.9% and 13.2%, respectively.S. faecium was the Group D streptococcus resistant to the most antibiotics andS. bovis was the most susceptible. Although most strains were only moderately susceptible to penicillin by disc susceptibility tests, minimum inhibitory concentrations of representative strains were in the susceptible range. Ampicillin susceptibilities ranged from 71% to 93%. About half of theS. faecium andS. avium strains were resistant to carbenicillin, but the other species were more susceptible. Vancomycin, furadantin, and chloramphenicol all had ≥ 82% susceptibilities to Group D streptococci. The widely divergent antibiotic susceptibilities of the Group D streptococci makes their specific susceptibility tests an essential part of optimal patient care.

Zusammenfassung

27 474 Probeabstriche aus Nase, Schlund, Zahnfleisch, Achselhöhle und Rektum von Patienten eines Krebszentrums ergaben die Isolation von insgesamt 4166 (= 17,4%) Streptokokkenstämmen der Gruppe D. Weitere 2217 Stämme wurden aus 7106 Harnproben und 58 Stämme aus 5286 Blutproben isoliert. Annähernd 11% der Zahnfleischkulturen ergaben Streptokokken der Gruppe D.Streptococcus faecalis überwog, gefolgt vonS. bovis, S. faecium, S. avium, S. equinus undS. durans. Sechs von elf prämortalen,S. faecalis-positiven Blutkulturen zeigten auch Wachstum anderer Organismen, insbesondere gramnegativer Bakterien. Sieben postmortale Blutproben ergabenS. faecalis zusammen mit gramnegativen Bakterien oder Hefen. Bei Abszessen und Verletzungen betrugen die Isolate 7,9% bzw. 13,2%. Als Streptococcus der Gruppe D erwies sichS. faecium gegenüber den meisten Antibiotika resistent undS. bovis am empfindlichsten. Obwohl sich im Blättchentest die meisten Stämme nur als mäßig Penicillin-empfindlich erwiesen, lag die minimale Hemmkonzentration repräsentativer Stämme im empfindlichen Bereich. Die Empfindlichkeit gegen Ampicillin schwankte zwischen 71 und 93%. Etwa die Hälfte der Stämme vonS. faecium undS. avium waren gegen Carbenicillin resistent, doch waren die anderen Spezies empfindlicher. Bei Vancomycin, Furadantin und Chloramphenicol lag die Empfindlichkeit von Streptokokken der Gruppe D über 82%. Die breite Streuung der Empfindlichkeit von Streptokokken der Gruppe D läßt ihre spezifische Testung zum wesentlichen Bestandteil optimaler Patientenbetreuung werden.

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Authors and Affiliations

  1. Clinical Oncology Branch, Baltimore Cancer Research Center, National Cancer Institute, University of Maryland Hospital, 22 South Greene St., 21201, Baltimore, Maryland, USA

    V. M. Young, M. J. Morris B. S., M. R. Moody M. S.,  S. C. Schimpff & P. H. Wiernik

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  1. V. M. Young
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  2. M. J. Morris B. S.
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  3. M. R. Moody M. S.
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  4. S. C. Schimpff
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  5. P. H. Wiernik
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Young, V.M., Morris, M.J., Moody, M.R. et al. An analysis of Group D streptococci recovered from cancer patients. Infection 6, 98–104 (1978). https://doi.org/10.1007/BF01642256

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