Group D Streptococcal Bacteremia, with Emphasis on the Incidence and Presentation of Infections Due toStreptococcus bovis

Abstract

Procedures routinely in use in many hospital microbiology laboratories do not distinguish between enterococci and nonenterococcal Group D streptococci. During a 15-month period we observed 11 patients with bacterial endocarditis due to Group D streptococci, eight of which were due to the nonenterococcal species, Streptococcus bovis. This micro-organism showed in vitro susceptibility to a wide variety of antimicrobial agents, including oxacillin and lincomycin. In patients with S. bovis infection, high serum bacteriostatic and bactericidal levels were achieved with penicillin or clindamycin alone, or penicillin and an aminoglycoside. The clinical response was equivalent with all drug regimens. In contrast, enterococci were more resistant in vitro to antibiotics, and in vivo definitely lower serum bactericidal activity was achieved.