Relevance of group Milieri streptococci in thoracic surgery: A clinical update

I. Stelzmueller, M. Biebl, N. Berger, M. Eller, J. Mendez, M. Fille, K. Angerer, T. Schmid, I. Lorenz, R. Margreiter, H. Bonatti

Research output: Contribution to journalReview article

12 Scopus citations

Abstract

Group Milleri streptococci (GMS), a heterogeneous group of streptococci, are associated with purulent infections. This study was a retrospective analysis of all consecutive thoracic infections of GMS between 2001 and 2004. Of 246 surgical GMS infections, thoracic infections accounted for 4.5 per cent, including 10 pleural infections (eight empyemas and two infected pleural effusions) and one mediastinal infection. The etiology of pleural infection was parapneumonic (7), second to esophageal perforation (1), liver transplantation (1), and liver resection (1). Polymicrobial infections were present in 64 per cent. All patients underwent removal of the infected masses, including drainage (3), thoracoscopic decortication (5), thoracotomy with debridement (2), and incision with drainage (1). The case fatality rate was 9 per cent (there was one patient with congestive heart disease unfit to undergo surgical empyema evacuation) and the recurrence rate was 27.3 per cent (three patients). Combined antibiotic/surgical treatment was successful in all other cases. GMS isolates were susceptible to clindamycin and all β-lactam antibiotics except ceftazidime, but were resistant to aminoglycosides. If found intrathoracically, GMS frequently progress to severe empyema. Therefore, timely removal of pleural collection by percutaneous drainage or surgical intervention seems indicated. If surgery is required, thoracoscopic decortication may be the preferred approach.

Original languageEnglish (US)
Pages (from-to)492-497
Number of pages6
JournalAmerican Surgeon
Volume73
Issue number5
StatePublished - May 1 2007

ASJC Scopus subject areas

  • Surgery

Fingerprint Dive into the research topics of 'Relevance of group Milieri streptococci in thoracic surgery: A clinical update'. Together they form a unique fingerprint.

  • Cite this

    Stelzmueller, I., Biebl, M., Berger, N., Eller, M., Mendez, J., Fille, M., Angerer, K., Schmid, T., Lorenz, I., Margreiter, R., & Bonatti, H. (2007). Relevance of group Milieri streptococci in thoracic surgery: A clinical update. American Surgeon, 73(5), 492-497.