Kavya S, Arvinda H R, Veenakumari H B, PrabuRaj A R, Smitha N R, Jyothi Diwakar, Dwarakanath Srinivas, Nagarathna S
Department of Neuromicrobiology, NIMHANS, India.
Department of Neuro Imaging and Interventional Radiology, NIMHANS, India.
Indian J Med Microbiol. 2023 Sep-Oct;45:100395. doi: 10.1016/j.ijmmb.2023.100395. Epub 2023 Jun 9.
• To study the incidence of Streptococcus anginosus group (SAG) in pyogenic or community acquired intra cerebral abscess. • To understand the risk factors for the same. • To analyze the specific radiological features and clinical outcome after surgery and antibiotic therapy.
This is a retrospective observational study of case series over a period of one year. Patients diagnosed with intracerebral abscess were included in the study. Pus collected from were received in the laboratory and processed according to the standard protocols. Data regarding the clinical findings and demographics were collected from medical records.
A total of 202 samples were studied. 103 were found to be pyogenic. SAG were isolated from 21 samples (20.38%) and all the isolates were sensitive to Penicillin. Age of the patients ranged from 18months to 68years. Male preponderance was noted with male to female ratio of 4:1. Otogenic infections were the most common predisposing factors and focus of infection could not be ascertained in 5 patients. All patients were treated with surgical intervention and antibiotics (Vancomycin, Amikacin and Metronidazole) for 6 weeks and recovery was remarkable. One patient succumbed to the illness.
SAG can be an aggressive pathogen with propensity for abscess formation. Chronic Suppurative Otitis Media (CSOM) is still a major cause of intracerebral abscess in developing country like India which is a benign and curable disease and should not be neglected. Injudicious use of antibiotics and negligence regarding the dose and duration of therapy from both patients and health care providers is the major cause for common infections to become more difficult to treat and succumbing to complications.
• 研究咽峡炎链球菌群（SAG）在化脓性或社区获得性脑脓肿中的发生率。• 了解其危险因素。• 分析手术及抗生素治疗后的特定影像学特征和临床结局。
这是一项为期一年的病例系列回顾性观察研究。研究纳入诊断为脑脓肿的患者。从脓肿收集的脓液送至实验室并按照标准方案进行处理。从病历中收集有关临床表现和人口统计学的数据。
共研究了202份样本。发现103份为化脓性。从21份样本（20.38%）中分离出SAG，所有分离株均对青霉素敏感。患者年龄范围为18个月至68岁。男性占优势，男女比例为4:1。耳源性感染是最常见的诱发因素，5例患者无法确定感染源。所有患者均接受了手术干预和抗生素（万古霉素、阿米卡星和甲硝唑）治疗6周，恢复情况显著。1例患者死亡。
SAG可能是一种具有形成脓肿倾向的侵袭性病原体。在印度这样的发展中国家，慢性化脓性中耳炎（CSOM）仍然是脑脓肿的主要原因，这是一种良性且可治愈的疾病，不应被忽视。患者和医护人员对抗生素的不当使用以及对治疗剂量和疗程的疏忽是常见感染变得更难治疗并导致并发症的主要原因。
