Класифікація Ланцефільда*
Lancefield Group | Species | Hemolysis | Associated Diseases | Treatment |
|---|---|---|---|---|
A | Streptococcus pyogenes | Beta | Pharyngitis, tonsillitis, wound and skin infections, septicemia, scarlet fever, pneumonia, rheumatic fever, glomerulonephritis, endocarditis (rare) | Penicillin Erythromycin, clindamycin (resistance increasing in the United States) |
Necrotizing fasciitis | Expeditious surgical management Beta-lactam (usually broad spectrum until etiology is identified; if the presence of GABHS is confirmed, penicillin or cefazolin can be used) plus clindamycin | |||
B | S. agalactiae | Beta | Sepsis, postpartum or neonatal sepsis, meningitis, skin infections, endocarditis, septic arthritis, urinary tract infection | Penicillin or ampicillin, cephalosporins, vancomycin |
C and G | S. equi, S. equimilis, S. zooepidemicus, S. canis | Beta | Pharyngitis, pneumonia, cellulitis, pyoderma, erysipelas, impetigo, wound infections, puerperal sepsis, neonatal sepsis, endocarditis, septic arthritis Human infection with group C implies a zoonotic origin | Penicillin, vancomycin, cephalosporins, macrolides (variable susceptibility) |
D | Enterococcal:† Enterococcus faecalis, E. faecium Nonenterococcal: S. gallolyticus (formerly S. bovis), S. equinus | Alpha or gamma | Endocarditis, urinary tract infection, intra-abdominal infection, cellulitis, wound infection as well as concurrent bacteremia | Penicillin, ampicillin, vancomycin (plus an aminoglycoside for serious infection) Vancomycin-resistant enterococci: Streptogramins (quinupristin/dalfopristin), oxazolidinones (linezolid), lipopeptide (daptomycin) |
S. gallolyticus (formerly S. bovis biotype I) | Colonic adenomas or carcinomas, endocarditis | |||
Viridans‡ | S. mutans, S. sanguis, S. salivarius, S. mitis (formerly S. mitior), S. anginosus (formerly S milleri), S. constellatus, S. intermedius | Alpha or gamma | Endocarditis, bacteremia, meningitis, localized infection, abscesses (particularly S. anginosus) | Penicillin, ampicillin, vancomycin (plus an aminoglycoside for serious infection), other antibiotics based on in vitro susceptibility |
S. suis | Meningitis, sometimes toxic shock syndrome | |||
S. iniae | Cellulitis, invasive infections from fish | Penicillin | ||
* This table includes only the most clinically relevant of the 20 Lancefield groups. | ||||
† Enterococci were initially included among the group D streptococci but are now classified as a separate genus even though they do express Lancefield group D antigens. | ||||
‡ Do not conform to specific Lancefield serogroups. | ||||
GABHS = group A beta-hemolytic streptococci. | ||||