Clinical characteristics and drug resistance analysis of Streptococcal bloodstream infections
Objective:To provide a theoretical basis for the diagnosis and treatment of Streptococcal bloodstream infection by collecting the clinical data of patients with Streptococcal bloodstream infection,analyzing and summarizing the clinical characteristics and drug susceptibility.Methods:Patients with Streptococcus isolated and identified from blood culture and diagnosed as bloodstream infection from Northern Jiangsu People's Hospital Affiliated to Yangzhou University from January 2020 to December 2022 were retrospectively collected,and their clinical data and drug susceptibility test results were ana-lyzed.Results:Among the 146 patients with Streptococcal bloodstream infection,the median age was 61(50,73)years old.There were 133 patients(91.1%)with one or more underlying diseases,including 80 patients(54.8%)with chronic diseases and 33 patients(22.6%)with malignant tumors.There were 59 cases(40.4%)of Streptococcus bloodstream infection complicated with pulmonary infection and 20 cases(13.7%)of Streptococcus bloodstream infection complicated with infective endocarditis.Streptococcus mitis(S.mitis,39 cases,26.7%),Streptococcus dysgalactiae(S.dysgalactiae,20 cases,13.7%)and Streptococcus anginosus(S.anginosus,18 cases,12.3%)were the most commonly isolated strains.The drug resistance rates of S.mitis to peni-cillin,cefotaxime and levofloxacin were 9.1%,2.6%and 6.1%.Chloramphenicol and quinupristin/dalfopristin were all sensi-tive to S.mitis.The resistance rates of S.anginosus to penicillin,cefotaxime and chloramphenicol were 5.9%,5.5%and 5.5%.All strains were sensitive to levofloxacin and quinupristin/dalfopristin.The resistance rates to clindamycin and erythromycin were close to 40%in both strains,and no strains were resistant to vancomycin and linezolid.S.dysgalactiae was sensitive to penicillin,linezolid,vancomycin,cefotaxime,chloramphenicol and levofloxacin,but was highly resistant to erythromycin,clin-damycin and tetracycline.Conclusion:Patients with chronic underlying diseases and malignant tumors are susceptible to Streptococcus,and Streptococcal bloodstream infection is easily accompanied by pulmonary infection and infective endocarditis.Streptococcus has a high resistance rate to erythromycin,clindamycin and tetracycline,and Streptococcus viridis has a certain resistance rate to penicillin.Although penicillin is a routine drug in clinical treatment,we should also pay attention to the drug susceptibility,avoid irrational drug use,and improve the cure rate of the disease.
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