Backgrounds: Facial infections are frequently caused by Streptococcus species, and the recent data about this hasn't been much. This study investigated the recent epidemiological features, microbiological patterns, and clinical outcomes of facial streptococcal infections in hospitalized adults.
Methods: A retrospective analysis was performed on 1,001 adult patients(18–94 years) hospitalized for facial infections at a single university hospital in Korea between January 2015 and December 2024. Among these, 686 patients showed streptococcal isolates from pus or wound. Clinical data were evaluated through medical record review, microbiological findings, and treatment outcomes.
Results: Three hundred patients(43.7%) were male, and the mean age of total patients was 57.3 ± 17.6 years. Common comorbidities included diabetes mellitus(DM, n=284, 41.4%) and renal failure(RF, n=17, 2.5%). The most predominant clinical presentations were facial cellulitis or abscess(n=435), followed by osteomyelitis(n=108), sialadenitis(n=70), periodontal(n=53), and peritonsillar infections(n=13). The most frequent isolates were Streptococcus mitis/oralis(n=162), S.constellatus(n=130), and S.anginosus(n=129). Five patients(0.7%) showed bacteremia. Systemic inflammatory response syndrome(SIRS) developed in 46 patients (6.7%), predominantly associated with S.anginosus and S.constellatus (13 isolates each). SIRS is significantly associated with DM(63.0%, p=0.003) and RF(10.9%, p=0.001). No significant correlation was found between ampicillin resistance and SIRS occurrence(10.9% vs. 5.9%, p=0.081). Major surgical intervention was required in 87 patients(12.7%), and the 30-day mortality rate was 0.3%(n=2).
Conclusion: Facial infections with Streptococcus species can cause more SIRS in patients with DM and RF. In particular, S.anginosus and S.constellatus demonstrate some possible association with SIRS development.