Empiric antibiotic choice for a pyogenic abscess should be directed at the microbes typically responsible, which include aerobic enteric Gram-negative bacilli (Escherichia coli and Klebsiella pneumoniae, the latter particularly prevalent in Asia), Gram-positive cocci (most commonly the Streptococcus milleri
group but also including Staphylococcus aureus, Streptococcus pyogenes, and Enterococcus spp.), and anaerobes (Bacteriodes, Fusobacterium, Actinomyces, and anaerobic streptococci) [10, 11].
Setting of acquisition Microorganism Community- Nosocomial acquired N (%) N (%) Gram-positive Abiotrophia species 1 (100) 0 Enterococcus faecalis 5 (71.4) 2 (28.6) Enterococcus gallinarum 1 (100) 0 Gemella haemolysans 1 (100) 0 Leuconostoc species 1 (100) 0 Listeria monocytogenes 0 3 (100) Staphylococcus aureus 0 1 (100) Staphylococcus capitis 2 (100) 0 Staphylococcus epidermidis 14 (87.5) 2 (12.5) Staphylococcus haemolyticus 2 (100) 0 Streptococcus agalactiae 0 3 (100) Streptococcus bovis II 0 1 (100) Streptococcus intermedius 0 1 (100) Streptococcus milleri
0 1 (100) Streptococcus mitis 0 1 (100) Streptococcus pneumoniae 0 19 (100) Streptococcus salivarius 0 1 (100) Gram-negative Acinetobacter baumannii 8 (100) 0 Acinetobacter lwoffii 2 (66.7) 1 (33,3) Brucella spp.
Garcia, "Purulent pericarditis with pneumopericardium caused by Streptococcus milleri
," Revista Espanola de Cardiologia, vol.
Dunbar, "Streptococcus intermedius, Streptococcus constellatus, and Streptococcus anginosus ('Streptococcus milleri
group') are of different clinical importance and are not equally associated with abscess," Clinical Infectious Diseases, vol.
Streptococcus intermedius, Streptococcus constellatus, and Streptococcus anginosus (the Streptococcus milleri
group): association with different body sites and clinical infections.
Streptococcus intermedius is part of the Streptococcus anginosus subgroup (formerly Streptococcus milleri
Bonomo, "Streptococcus anginosus (Streptococcus milleri
group) Pyomyositis in a 50-year-old man with acquired immunodeficiency syndrome: case report and review of literature," Infection, vol.
(Guthof); an indigenous organism of the human oral cavity.
was detected as an indicator of possible underlying gastrointestinal neoplasm .
During the procedure, neurosurgeons obtained approximately 40 ml of pus for bacteriologic culture, which grew Proteus mirabilis and Streptococcus milleri
. The patient was administered a 6-week course of multiple antibiotics that was designed according to the sensitivity pattern of the organisms.
Clinical and bacteriological significance of the Streptococcus milleri
group in deep neck abscesses [article in Japanese].