Alpha-hemolytic streptococcal bacteremia: a review of 203 episodes during 1980-1991.

This is a review of 203 episodes of alpha-hemolytic streptococcal bacteremia during a 12-year period (1980-91) in a large community teaching hospital in the USA. There were 87 male and 116 female patients, with ages ranging from newborn infants to a 96-year-old; 118 patients (58.1%) were 60 years or older. 31 patients had endocarditis, 93 had bacteremia, and 79 had polymicrobial bacteremia. Streptococcus sanguis, S. mitis, S. salivarius and S. intermedius accounted for 80% of the strains. Some strains were resistant to tetracycline, nafcillin, erythromycin or clindamycin. The overall mortality was 29.6% (60 of 203 patients). There was no significant difference in the mortality among patients with endocarditis, bacteremia, and polymicrobial bacteremia. Factors that adversely influenced the mortality rate were old age (60 years and older) and rapidly fatal or ultimately fatal underlying conditions.