European Journal of Cardiovascular Medicine

Background: Infections attributable to Streptococcus are protean. These range from mild skin and soft tissue infections to life-threatening conditions like meningitis, endocarditis and toxic shock syndrome. There appears to be a recent surge of invasive infections due to these organisms. Penicillin is drug of choice for majority of Streptococcal species. Objectives: Isolation, identification and antibiotic susceptibility of Streptococcus species from various samples to revise hospital empirical therapy with regards to penicillin allergic patients in whom Streptococcus species is isolated. Methods: This is a prospective study over the past 2 ½ years (January 2020-August 2022) that includes all the Streptococcal species, isolated from clinical specimen. These were identified using ID GP card, Vitek-Compact 2. Antibiotic susceptibility was performed using AST 628 and ST03 cards. Results: There were 50 Streptococcal isolates from 50 patients. The ages ranged between 21 to 80 years; Males (61%) & Females(39%). The isolation of Streptococci from skin and soft tissue samples was high (55.3%) followed by respiratory samples (17%). Str.pyogenes (31.9%) and Str. agalactiae (25.5%) were predominantly isolated from skin and soft tissues, especially with lower limb cellulitis and necrotizing fasciitis. Str.pneumoniae (27.6%) were isolated mainly from lower respiratory infections in elderly patients. Other isolates included Str.mitis (6.3%), Str.viridians (2.1%) , Str.mutans (2.1%), Str.sanguis (2.1%) and Str.uberis (2.1%). Most of the isolates were susceptible to Penicillin & Ampicillin. Interestingly, susceptibility to macrolide and lincosamide was low. Conclusion: Str.pyogenes has emerged as an important cause of life-threatening skin and soft-tissue infections, especially necrotizing fasciitis. Using erythromycin or Clindamycin as empirical therapy in penicillin allergic patients should be cautioned due to low susceptibility at our hospital