Abstract
Group G Streptococcus (GGS) is associated with severe invasive soft tissue infection and toxic shock syndrome. A 38-year-old man was admitted for swelling of the right leg and fever. He presented with septic shock, acute renal failure, and disseminated intravascular coagulation. GGS (Streptococcus dysgalactiae subsp. equisimilis) was detected on culture of a swab from the skin of the right leg. Lower-limb amputation was performed because the serum level of CK was 16,863 IU/l. Antimicrobial susceptibility tests revealed no resistance to ampicillin (ABPC) or clindamycin (CLDM) but strong resistance to clarithromycin (CAM), levofloxacin (LVFX), and minocycline (MINO). We analyzed the results of 99 antimicrobial susceptibility tests for GGS performed between 2005 and 2009 in our hospital, and found that there was marked resistance to CAM (30.3%), LVFX (26.3%), and MINO (44.4%). Some of the strains tested showed strong resistance to ABPC and cephalosporins (7.1%). It is necessary to consider the existence of GGS resistant to macrolide derivatives or new quinolone derivatives when using these antibiotics for severe GGS infection.
