Group D streptococcus normally lives in the gastrointestinal system (bowels and gall bladder); there are a number of types with different names. It does not normally cause aggressive or life threatening infection, nor is it particularly associated with necrotising fasciitis, It may however be present if the NF is caused by mixtures of bacteria. However it can cause illness or aggravate pre-existing medical problems in adults or babies who have disease or surgery involving the bowel or gall bladder. It can also infect prosthetic (artificial) material such as heart valves, artificial joints, and venous catheters.

If the bacteria enter the bloodstream this will cause fevers but severe septic shock is not normally seen with this bacterium. It is not intrinsically dangerous but can aggravate an already complicated illness. Treatment usually involves antibiotics and doctors may have to consider removing any artificial material. Some strains are resistant to commonly used antibiotics which may make the infection difficult to treat.

By Shiranee Sriskandan FRCP. PhD. Imperial College London

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