It is thought that extracellular enzymes produced by these organisms may contribute to its pathogenicity by degradation og connective tissue. These enzymes include hyaluronidase deoxyribonuclease, ribonuclease, gelatinase and collagenase. The S. milleri group also releases an immnusupressive subtances which has not been characterized. This unidentified substance may promote pathogenicity and allow the organismsto survive with an abscess. IStudies in a mouse model of pneumonai demonstrate S. milleri group organisms are susceptible to wide range of antibiotics including penicillins, cephalosporins, clindamycin, vancomycin and erythromycin.
Surgical evacuation is often necessary for bacterial eradication.
Although the S. milleri group organisms have received increasing attentions as potential pathogen in above mentioned infections, their role in these serious infections remains largely unrecognized. There are several explanations for this lack of recognition. First, it may due to the long period of confusion regarding streptococcal taxonimy and nomenclature. Second, the clinical microbiological characteristics of the S. milleri group may lead to misidentification. Third, the use of antibiotics before the collection of sample for analysis may greatly affect the results.