Infections Associated with the Streptococcus Anginosus Group in Children.

OBJECTIVES

Streptococcus anginosus group (SAG), also known as the Streptococcus milleri group, consists of Streptococcus anginosus, Streptococcus intermedius and Streptococcus constellatus. Skin and soft tissue infections, intra-abdominal infections, skeletal infections and ear-nose-throat (ENT) and cervical infections are the most common presentations. This study aimed to evaluate SAG infections in children.

METHODS

A retrospective review was conducted on patients aged 0-18 years who had cultures positive for S. anginosus, S. intermedius, or S. constellatus between January 1, 2019, and March 1, 2024.

RESULTS

SAG bacteria were cultured in 113 patients. SAG was identified as the causative agent of infection in 93 patients. Of a total of 93 patients, 39 were female (41.9%) and 54 were male (58.1%). The median age of the patients at the time of diagnosis was 14 years (IQR: 9-17). Among these, S. constellatus was found in 46 patients (49.5%), S. anginosus in 36 patients (38.7%), and S. intermedius in 11 patients (11.8%). The infections presented primarily as skin and soft tissue infections (63 patients), head and neck infections (23 patients), and intra-abdominal abscesses (7 patients). Additionally, two patients had concomitant bacteremia. Predisposing factors for the development of infection were identified in 52 patients (55.3%). Surgical drainage was required for 70 patients (74.4%).

CONCLUSION

Streptococcus constellatus was the most frequently isolated species among the SAG, followed by S. anginosus and S. intermedius. The most common site of infection was skin and soft tissue, with a significant proportion of patients requiring surgical drainage. The overall incidence of bacteremia was low. S. intermedius was more frequently isolated from deep tissue infections.