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Clinical characteristics and significance of Streptococcus salivarius bacteremia and Streptococcus bovis bacteremia: a prospective 16-year study

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Abstract

The aim of this study was to determine the clinical significance of Streptococcus salivarius isolates recovered from blood cultures and compare them with isolates of Streptococcus bovis biotypes I and II. Seventeen of the 52 (32%) S. salivarius isolates recovered were considered clinically significant, compared with 62 of the 64 (97%) S. bovis isolates (p<0.0001). Bacteremia caused by S. salivarius occurred mostly in patients who showed relevant disruption of the mucous membranes and/or serious underlying diseases. Patients with S. salivarius bacteremia were younger than those with S. bovis bacteremia (57 vs. 67 years; p<0.01). Patients with S. salivarius bacteremia and patients with S. bovis II bacteremia had similar rates of endocarditis, colon tumors, and noncolon cancer. On the other hand, when compared with S. bovis I bacteremia, S. salivarius bacteremia was associated with lower rates of endocarditis (18% vs. 74%, respectively) (p<0.01) and colon tumors (0% vs. 57%, respectively) (p<0.005) and higher rates of noncolon cancer (53% vs. 9.5%, respectively) (p<0.01). Bacteremia caused by S. bovis II had a hepatobiliary origin in 50% of the patients, while, in contrast, that due to S. salivarius or S. bovis I was less frequently associated with a hepatobiliary origin (12% and 5%, respectively) (p<0.00001). The rate of penicillin resistance was 31% among S. salivarius isolates and 0% among S. bovis isolates (p<0.0001). In conclusion, the clinical characteristics of S. salivarius bacteremia and S. bovis II bacteremia are similar, and the isolation of S. salivarius in blood should not be systematically regarded as contamination.

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References

  1. Whiley R, Beighton D (1998) Current classification of the oral streptococci. Oral Microbiol Immunol 13:195–216

    Google Scholar 

  2. Sanders CC, Sanders Jr WE (1982) Enocin: an antibiotic produced by Streptococcus salivarius that may contribute to protection against infections due to group A streptococci. J Infect Dis 146:683–690

    Google Scholar 

  3. Facklam R (2002) What happened to the streptococci: overview of taxonomic and nomenclature changes. Clin Microbiol Rev 15:613–630

    Google Scholar 

  4. Ruoff K, Ferraro M, Holden J, Kunz L (1984) Identification of Streptococcus bovis and Streptococcus salivarius in clinical laboratories. J Clin Microbiol 20:223–226

    Google Scholar 

  5. Coykendall A, Gustafson K (1985) Deoxyribonucleic acid hybridizations among strains of Streptococcus salivarius and Streptococcus bovis. Int J Syst Bacteriol 35:274–280

    Google Scholar 

  6. Ruoff K, Miller S, Garner C, Ferraro M, Calderwood S (1989) Bacteremia with Streptococcus bovis and Streptococcus salivarius: clinical correlates of more accurate identification of isolates. J Clin Microbiol 27:305–308

    Google Scholar 

  7. Schlegel L, Grimont F, Ageron E, Grimont P, Bouset A (2003) Reappraisal of the taxonomy of the Streptococcus equinus complex and related species: description of Streptococcus gallolyticus subsp. gallolyticus subsp. nov., S. gallolyticus subsp. macedonicus subsp. nov and S. gallolyticus subsp. pasteurianus subsp. nov. Int J Syst Evol Microbiol 53:631–645

    Google Scholar 

  8. Brennan R, Durack D (1984) The viridans streptococci in perspective. In: Remington JS, Swartz MN (ed) Current clinical topics in infectious diseases, vol. 5. McGraw Hill, New York, pp 253–289

    Google Scholar 

  9. Swenson F, Rubin S (1982) Clinical significance of viridans streptococci isolated from blood cultures. J Clin Microbiol 15:725–727

    Google Scholar 

  10. Ruiz M, Soriano F (1994) Significado clínico de la bacteriemia por estreptococos del grupo viridans. Enf Infecc Microbiol Clin 12:426–432

    Google Scholar 

  11. Cabellos C, Viladrich P, Corredoira J, Verdaguer R, Ariza J, Gudiol F (1999) Streptococcal meningitis in adult patients: current epidemiology and clinical spectrum. Clin Infect Dis 28:1104–1108

    Google Scholar 

  12. Heidemann D, Dunns S, Haimamn M (1989) S. salivarius endophthalmitis from contaminated donor cornea after keratoplasty. Am J Ophtalmol 107:429–430

    Google Scholar 

  13. Bouvier M, Lejerine E, Rouillat M, Wolfrom C (1979) Osteite femorale avec isolement in situ d’un Streptococcus salivarius. Nouv Presse Med 8:3899–3900

    Google Scholar 

  14. Romero M, Larraona JL (1999) Pancreatic abscess due to Streptococcus salivarius after dental manipulation. Am J Gastroenterol 94:1987–1988

    Google Scholar 

  15. Cunliff N, Jacob A (1997) Streptococcus vestibularis bacteraemia. J Infect 34:85

    Google Scholar 

  16. Partridge S (2000) Prosthetic valve endocarditis due to Streptococcus vestibularis. J Infect 41:284–285

    Google Scholar 

  17. Doyuk E, Ormerod O, Bowler I (2002) Native valve endocarditis due to Streptococcus vestibularis and Streptococcus oralis. J Infect 45:39–41

    Google Scholar 

  18. Avada A, van der Auwera P, Meunier F, Daneau D, Klasterky J (1992) Streptococcal and enterococcal bacteremia in patients with cancer. Clin Infect Dis 15:33–48

    Google Scholar 

  19. Hoecker JL, Pickering D, Groschel D, Kohl S (1978) Streptococcus salivarius sepsis in children with malignancies. J Pediatr 92:337–338

    Google Scholar 

  20. Carratalá J, Alcaide F, Fernández-Sevilla A, Corbella X, Liñares J, Gudiol F (1995) Bacteremia due to viridans streptococci that are highly resistant to penicillin: increase among neutropenic patients with cancer. Clin Infect Dis 20:1169–1173

    Google Scholar 

  21. Ruoff K, Whiley R, Beighton D (2003) Streptococcus. In: Murray P, Baron E, Pfaller M, Yolken R(eds) Manual of clinical microbiology. ASM Press, Washington DC, pp 405–421

    Google Scholar 

  22. Coykendall A (1989) Classification and identification of the viridans streptococci. Clin Microbiol Rev 2:315–325

    Google Scholar 

  23. National Committee for Clinical Laboratory Standards (2000) Performance standards for antimicrobial disk susceptibility testing. Approved standard M2-A7. NCCLS, Wayne, PA

  24. National Committee for Clinical Laboratory Standards (2002) Performance standards for antimicrobial susceptibility testing. Informational supplement M100-S12. NCCLS, Wayne, PA

  25. Weinstein M, Towns M, Quartey S, Mirrett S, Reimer L, Parmigiany G (1996) The clinical significance of positive blood cultures in the 1990s: a prospective comprehensive evaluation of the microbiology, epidemiology, and outcome of bacteremia and fungemia in adults. Clin Infect Dis 24:584–602

    Google Scholar 

  26. Durack D, Lukes A, Bright D (1994) New criteria for diagnosis of infective endocarditis: utilization of specific echocardiographic findings. Am J Med 96:200–209

    Google Scholar 

  27. Facklam R (1997) Physiological differentiation of viridans streptococci. J Clin Microbiol 5:184–201

    Google Scholar 

  28. Parker M, Ball L (1976) Streptococci and aerococci associated with systemic infection in man. J Med Microbiol 9:275–302

    Google Scholar 

  29. Watanakunakorn C, Pantelakis J (1993) Alfa-hemolytic streptococcal bacteremia: a review of 203 episodes during 1980–1991. Scand J Infect Dis 25:403–408

    Google Scholar 

  30. Bryan C (1989) Clinical implications of positive blood cultures. Clin Microbiol Rev 2:329-353

    Google Scholar 

  31. Guerrero AL, Guerrero A (2002) Meningitis por Streptococcus salivarius y fístula espontánea: a propósito de un caso. Rev Neurol 35:799–800

    Google Scholar 

  32. Lark R, Chenoweth C, Saint S, Zemencuk J, Lipsky B, Plorde J (2000) Four-year prospective evaluation of nosocomial bacteremia: epidemiology, microbiology, and patient outcome. Diag Microbiol Infect Dis 38:131–140

    Google Scholar 

  33. Klein R, Recco R, Catalano M, Edberg S, Casey J, Steigbigel N (1977) Association of Streptococcus bovis with carcinoma of the colon. N Engl J Med 297:800–802

    Google Scholar 

  34. Roses D, Richman H, Localio S (1974) Bacterial endocarditis associated with colorectal carcinoma. Ann Surg 179:190–191

    Google Scholar 

  35. Alcaide F, Liñares J, Pallarés R, Carratalá J, Benitez M, Gudiol F, Martín R (1995) In vitro activities of 22 beta-lactam antibiotics against penicillin-resistant and penicillin-susceptible viridans group streptococci isolated from blood. Antimicrob Agents Chemother 39:2243–2247

    Google Scholar 

  36. Doern G, Ferraro M, Brueggemann A, Ruoff K (1996) Emergence of high rates of antimicrobial resistance among viridans group streptococci in the United States. Antimicrob Agents Chemother 44:891–894

    Google Scholar 

  37. Tuohy M, Washington J (1997) Antimicrobial susceptibility of viridans group streptococci. Diagn Microbiol Infect Dis 29:277–280

    Google Scholar 

  38. Carratalá J, Gudiol F (1995) Life-threatening infections due to penicillin-resistant viridans streptococci. Curr Opin Infect Dis 8:123–126

    Google Scholar 

  39. Dajani AS, Tauber KA, Wilson W, Bolger A, Bayer A, Ferrieri P (1997) Prevention of bacterial endocarditis: recommendations by the American Heart Association. JAMA 277:1794–1801

    Google Scholar 

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Acknowledgement

The authors thank Javier Ariza for his comments and his review of the manuscript. This work was supported in part by a grant from the Public Health Service of Galicia, Spain (PGDIT.00.SAN.00007-PR)

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Correspondence to J. C. Corredoira.

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Corredoira, J.C., Alonso, M.P., García, J.F. et al. Clinical characteristics and significance of Streptococcus salivarius bacteremia and Streptococcus bovis bacteremia: a prospective 16-year study. Eur J Clin Microbiol Infect Dis 24, 250–255 (2005). https://doi.org/10.1007/s10096-005-1314-x

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