Difficult streptococci.

Streptococci pose difficulties in laboratory and clinical diagnosis and in therapy. They are important pathogens with both potential for high mortality in acute infections and endocarditis, and recurrence and persistence in foreign-body associated infections. Prevention of serious infection and spread of infection pose a number of hospital problems but hospital difficulties may originate in community wide outbreaks which also require investigation and control. Our experience with septicaemia caused by Lancefield Group A streptococci, and with Group D streptococcal bacteraemia in liver transplant recipients are reported and both national and international problems with antibiotic resistant streptococci are reviewed.