Group G strep

[lrnpgrl87]

I was wondering if my fellow nurses can tell me more about group G strep. I recently had a patient that met CENTOR criteria and was treated, then 2 months later same presentation and cultured heavy growth of group G strep, then again in 2 months same thing. patient is a pediatric patient. I have never heard of Group G strep, nor do I have any idea of what to do with preventing this infection from coming back. Any advice?

[pro-student]

Group G Strep are part of the normal flora in the airway, skin, and reproductive tract. Something like 25% of adults carry GGS in their pharynx. Occasionally, these bacteria can cause infection including bacteremia, endocarditis, septic arthritis, pharyngitis, and soft tissue infections. They are susceptible to penicillin and third generation celphalosporins (usually cefotaxime or ceftriaxone).

Recurrent pharyngitis isn't unheard of in kids. Make sure they are taking all the abx, throw out toothbursh, aren't sharing dishes or utensils, check contact including school/childcare for potential reinfection, considered testing for abx resistance. There is also a chance that this child is a carrier (and normal flora GGS is what was cultured) and the recurrent pharyngitis has another cause, maybe viral. If it is recurrent GGS, adding another abx would probably the next step in treatment after ruling out other causes of treatment failure.