Group C streptococci isolated from throat swabs: a laboratory and clinical study.

AIMS: To determine the prevalence of beta haemolytic, Lancefield group C streptococci in throat swabs taken in routine clinical practice, and correlate the species identified with presenting clinical features. METHODS: One year, laboratory based prospective study, using a questionnaire to elicit clinical information. RESULTS: 4.4% of throat swabs yielded group C streptococci, of which 38% belonged to S equisimilis and 53% to S anginosus-milleri group (SAM). Pyrexia was more common in patients with S equisimilis, but other clinical features did not differ significantly between the two groups. No S zooepidemicus was isolated. CONCLUSIONS: Species identification of group C streptococci from throat swabs does not appear to be clinically useful in this patient population. However, the prevalence and spectrum of organisms is similar to that reported in N America, where studies suggest a possible role in some cases of severe pharyngitis. Observational studies such as this lack power to resolve the issue of pathogenicity, for which a placebo controlled trial of antibiotic treatment is ideally required.

Convalescent excretion of Salmonella enteritidis in infants.

OBJECTIVES: To review the excretion of Salmonella enteritidis PT4 in the faeces of infants involved in a point-source outbreak in a nursery, and to relate these findings to advice given by the Outbreak Control Team (OCT). METHODS: Retrospective laboratory-based survey. RESULTS: Infection with S. enteritidis PT4 was microbiologically confirmed in 33 primary cases and one secondary case. Of the faeces submitted 4 weeks from exposure, 96% remained positive. None of the infants was symptomatic by this time, and none received antimicrobial treatment. Two infants aged less than 1 year were still excreting 22 weeks after the onset of the outbreak. CONCLUSIONS: As for other serotypes, S. enteritidis PT4 causes prolonged symptomless excretion after infection, particularly in infants aged less than 1 year. Infection control measures, including exclusion criteria, may need to be modified as an outbreak progresses.

Streptococcus milleri and complex groin abscesses in intravenous drug abusers.

Intravenous drug abuse is an increasing problem. Septic complications occur frequently at the injection site, especially in the groin where large abscesses around the femoral vessels can threaten life or limb. We report four patients with extensive or complex groin abscesses following attempted self-injection into the femoral vein. Streptococcus milleri was cultured from all of these abscesses and prompted a review of the isolation of this organism in this hospital.