Tresadern J C, Farrand R J, Irving M H
Ann R Coll Surg Engl. 1983 Mar;65(2):78-9.
For many years Viridans streptococci have been considered as commensal organisms in a wide variety of sites in the human body and only regarded as significant pathogens in subacute bacterial endocarditis. However, in recent years some reports have suggested that a particular species, Streptococcus milleri, can be a virulent pathogen, producing life-threatening sepsis particularly in surgical patients. We review here our experience of this organism in 23 general surgical patients over a 3 year period, and postulate that prophylactic use of antibiotic combinations such as gentamicin and metronidazole in patients undergoing colo-rectal surgery may be a factor promoting its emergence as a significant pathogen. Patients with established sepsis due to Streptococcus milleri should be considered for long-term antibiotic therapy as part of the treatment of their abscesses.
多年来，草绿色链球菌一直被视为人体多种部位的共生菌，仅在亚急性细菌性心内膜炎中被视为重要病原体。然而，近年来一些报告表明，一种特定的菌种——米勒链球菌，可能是一种毒性很强的病原体，尤其在外科手术患者中可引发危及生命的败血症。在此，我们回顾了3年期间23例普通外科患者感染这种病菌的经历，并推测在结直肠手术患者中预防性使用抗生素组合（如庆大霉素和甲硝唑）可能是促使其成为重要病原体的一个因素。对于已确诊因米勒链球菌导致败血症的患者，应考虑将长期抗生素治疗作为其脓肿治疗的一部分。
