Microaerophilic streptococcal infection in children.

A total of 148 isolates of microaerophilic streptococci (MS) (47 Streptococcus constellatus, 43 Streptococcus intermedius and five Gemella morbillorum) were cultured from 123 children. There were predisposing conditions in 47 (38%) patients of which most common were previous surgery (14), trauma (11), malignancy (9) diabetes (6) and immunodeficiency (5). MS were the only bacteria isolated from 12 (10%) patients and mixed infections were encountered in 111, when the number of isolates varied between two and seven (average 3.0) isolates per specimen. The bacteria most commonly isolated with MS were anaerobic cocci (70 isolates), Bacteroides fragilis group (54), pigmented Prevotella and Porphyromonas (34) and Escherichia coli (26). Most B. fragilis and E. coli were recovered from intra-abdominal infections, and those of skin and soft tissue adjacent to the rectum. Most pigmented Prevotella and Fusobacteria were isolated from oropharyngeal, pulmonary, head and neck sites. Most MS were recovered from abscesses (43%), the abdominal cavity (17%), sinuses (10%) and chest infections (9%). Antimicrobial therapy was administered to all patients, in 61 this was combined with surgical drainage or correction. Three patients died. These data illustrate that MS can occasionally be associated with infection in children.