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The purpose of this investigation was to provide a comprehensive review of the pathogenic role and spectrum of disease of milleri group streptococci, with special attention to bloodstream invasion and to possible differential roles among the three species. All consecutive isolates of milleri group streptococci from any anatomic source, during a 37-month period, in a tertiary care teaching hospital in Tel-Aviv, Israel, were thoroughly investigated. Identification to the species level was performed by an automated system.Streptococcus anginosus constituted 82% of the 245 patient-unique isolates from hospitalized patients. All nonurinary isolates were involved in pyogenic infections mostly originating from the gastrointestinal tract, with bacteremia in 28 cases. The 71 urinary isolates represented either urinary tract infection or nonsignificant bacteriuria. No specific association could be detected between species and the infection site, except for a higher relative representation of Streptococcus constellatus in bacteremia. Milleri group streptococci are common in clinical practice and play a different pathogenic role to other viridans streptococci. Due to their invariable association with pyogenic processes, their presence in blood warrants immediate focus identification. In addition, they have a previously unappreciated clinical niche concerning urinary tract infection. The identification of viridans streptococci to the species level is of paramount clinical significance.
Infectious Diseases Unit, Tel-Aviv Sourasky Medical Center, 6 Weizman str., Tel-Aviv, 64239, Israel, firstname.lastname@example.org.
This article was published in the following journal.
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A large heterogeneous group of mostly alpha-hemolytic streptococci. They colonize the respiratory tract at birth and generally have a low degree of pathogenicity. This group of species includes STREPTOCOCCUS MITIS; STREPTOCOCCUS MUTANS; STREPTOCOCCUS ORALIS; STREPTOCOCCUS SANGUIS; STREPTOCOCCUS SOBRINUS; and the STREPTOCOCCUS MILLERI GROUP. The latter are often beta-hemolytic and commonly produce invasive pyogenic infections including brain and abdominal abscesses.
A subset of VIRIDANS STREPTOCOCCI, but the species in this group differ in their hemolytic pattern and diseases caused. These species are often beta-hemolytic and produce pyogenic infections.
A species of gram-positive bacteria in the STREPTOCOCCUS MILLERI GROUP. It is the most frequently seen isolate of that group, has a proclivity for abscess formation, and is most often isolated from the blood, gastrointestinal, and urogenital tract.
A species of gram-positive bacteria in the STREPTOCOCCUS MILLERI GROUP. It is commonly found in the oropharnyx flora and has a proclivity for abscess formation in the upper body and respiratory tract.
A species of gram-positive bacteria in the STREPTOCOCCUS MILLERI GROUP. It is commonly found in the oropharynx flora and has a proclivity for abscess formation, most characteristically in the CENTRAL NERVOUS SYSTEM and LIVER.
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