A Case of Streptococcus intermedius Empyema

Abstract

Despite historical in vitro susceptibility data of S. intermedius, antimicrobial therapy may be ineffective, and more extreme measures may be needed to achieve a successful outcome. Early, appropriate antimicrobial therapy needs to remain the mainstay of the treatment of CAP in an attempt to prevent fatal complications such as this from occurring.

A case report of multiple abscesses caused by Streptococcus intermedius

“… 6 Infection with S. intermedius is very rare in previously healthy individuals without any identifiable risk factors. 9 The two most common risk factors are dental manipulation and sinusitis. Others include a history of diabetes, heavy alcohol consumption, congenital heart disease, heart‐related conditions, malignancy, periodontal disease, preceding pneumonia, neurological diseases, and COPD.…”

“… 12 , 13 Most strains are resistant to aminoglycosides, and resistance to macrolides and clindamycin are increasing. 9 , 10 Empiric therapy should depend based on patients' current condition and whether they have been exposed to antimicrobials within the past 3 months 9 Fluoroquinolones have also been shown to be efficacious against SAG, but resistance develops quickly so these are not appropriate as empiric therapy. 10 The most commonly used antibiotic regimens currently used are a combination of ceftriaxone and metronidazole or a combination of ceftriaxone, metronidazole, and vancomycin.…”

mecA Gene Transferrability and Antibiogram of zoonotic Staphylococcus intermedius from Animals, Staff and the Environment in Animal Hospitals in Korea

“…S. intermedius isolates were cultured overnight on 5% sheep blood agar plates (Promed, Ansan, Korea) at 37 o C. The chromosomal DNA was extracted using the DNeasy tissue kit (Qiagen, Valencia, CA, U.S.A.) according to the manufacturer's instructions for Gram-positive bacteria, with a modification of the cell lysis step using 50 U/ml lysostaphin (Sigma-Aldrich), and amplified following a program described previously [4,33] using S. intermedius ATCC 29663 and S. aureus ATCC 29213 as reference strains.…”

“…Methicillin resistance in staphylococci is usually caused by the acquisition of a mobile gene element termed a staphylococcal cassette chromosome mec (SCCmec) [1,7], which is one of the major public health concerns because of the limited therapeutic options [6]. Much less is known of the SCCmec typing of methicillin-resistant S. intermedius (MRSI), which can cause pneumonia after a coronary bypass surgery, brain abscess, and empyema in humans [2,12,33]. In The Netherlands, the same MRSI strains were detected in infected surgical wounds from pets that had undergone surgery at the same animal hospital.…”

Human Staphylococcus intermedius Infection in a Patient With Postradiation Changes

“…3 In a report on dog biteYinduced wound infections, Talan and colleagues 4 were the first to demonstrate that S. intermedius can also lead to human infections. Subsequent studies have reported other human infections by S. intermedius including endocarditis, 5 bacteremia, 6 pneumonia, 7 otitis externa, 8 mastoiditis, 9 brain abscess, 10 empyema, 11 sinusitis, 12 and meningitis. 13 Microbiological identification of S. intermedius is more difficult because rapid coagulase tests are often negative, potentially leading to their misidentification as coagulase-negative staphylococci.…”