Volume 21, Number 2—February 2015
Dispatch
Streptococcus suis Infection in Hospitalized Patients, Nakhon Phanom Province, Thailand
, Jocelynn T. Owusu, Somsak Thammathitiwat, Darunee Ditsungnoen, Pimpawan Boonmongkon, Ornuma Sangwichian, Kriengkrai Prasert, Sankhom Srihapanya, Kanlaya Sornwong, Kazunori Oishi, Surang Dejsirilert, Henry C. Baggett, and Sonja J. Olsen
Table 2
Characteristics of 38 patients for whom blood culture confirmed Streptococcus suis infection, Nakhon Phanom Province, Thailand, 2006–2012
| Characteristic | Result of analysis or culture |
|---|---|
| Male sex, no. (%) | 28 (74) |
| Median age, y (range) | 50 (23–73) |
| Heavy alcohol use, no. (%)* | 20 (53) |
| Current smoker, i.e., smoked daily, no. (%) | 21 (55) |
| Underlying chronic disease, no. (%) | 12 (32) |
| Hypertension | 4 (33) |
| Diabetes | 3 (25) |
| Alcoholism† | 3 (25) |
| Heart disease | 1 (0.8) |
| Gout | 1 (0.8) |
| Occupation: farmer, no. (%)‡ | 33 (87) |
| Consumption of/contact with pig or pork product, no. (%) | 35 (92) |
| Days from pork/prok contact to illness onset, median (range) | 2 (1–7) |
| Days from illness onset to hospital admission, median (range) |
2 (0–5) |
| Clinical features | |
| Meningitis, no. (%) | 24 (63) |
| Septicemia, no. (%) | 10 (26) |
| Arthritis, no. (%) |
4 (11) |
| Laboratory investigation | |
| Complete blood count, n = 37 | |
| Leukocytosis, >10,000 cells/μL, no. (%) | 28 (76) |
| Leukopenia,<5,000 cells/μL, no. (%) | 1 (3) |
| Thrombocytosis, >450,000 cells/μL, no. (%) | 2 (5) |
| Thrombocytopenia, <150,000 cells/μL, no. (%) | 7 (19) |
| CSF examination,§ n = 12 | |
| Protein, mean ± SD, % | 580 ± 421 |
| Glucose, mean ± SD, mg/μL | 23 ± 19 |
| Leukocyte count, mean ± SD, cells/μL | 2,210 ± 1,580 |
| Polymorphonuclear neutrophils, mean ± SD, % | 54 ± 28 |
| Blood culture result reported by hospital laboratory¶ | |
| Streptococcus group D, non-enterococci, no. (%) | 30 (79) |
| Streptococcus group D, no. (%) | 2 (5) |
| Streptococcus pyogenes, no. (%) | 1 (3) |
| Group A β-hemolytic Streptococcus, no. (%) | 1 (3) |
| β-Hemolytic Streptococcus, no. (%) | 1 (3) |
| Streptococcus not group A,B,D, no. (%) | 1 (3) |
| Enterococcus spp., no. (%) | 1 (3) |
| Streptococcus spp., no. (%) | 1 (3) |
| CSF culture results reported by hospital laboratory, n = 6 | |
| Streptococcus group D, nonenterococci, no. (%) | 5 (83) |
| Streptococcus suis, no. (%) |
1 (17) |
| Days hospitalized, median (range)# | 7 (3–19) |
| Death, no. (%) | 0 |
| Permanent deafness, no. (%)** | 12 (32) |
*Defined as self-reported drinking of >2 alcoholic beverages/day or >14 drinks/week for men and >1 alcoholic beverage/day or >7 drinks/week for women.
†In 1, cirrhosis also was diagnosed.
‡Three raised livestock, and 30 harvested crops (rice).
§Reference values: protein, 15–45 mg/μL; glucose, 50–80 mg/μL; leukocytes, 0–5 cells/μL; polymorphonuclear neutrophils, 0%.
¶All 38 blood culture results were confirmed to be S. suis.
#Excludes 2 patients who experienced septic shock and were transferred to the regional hospital (in another province) on the first day of admission.
**Ten patients had bilateral deafness, of whom 2 with deafness reported chronic ataxia; all 12 had meningitis.