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Is Streptococcus bovis a urinary pathogen?

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Abstract

The Streptococcus bovis group (SBG) comprises several microorganisms associated with human infections. They have been associated with bacteremia, endocarditis, biliary tract infection, meningitis, and colorectal cancer, but their role as urinary pathogens is not well known. The objective of this investigation was to discover the incidence and clinical significance of the bacteriuria associated with this complex. A retrospective analysis of all adult patients with bacteriuria caused by SBG during the period 1995–2012 was carried out. During the study period, SBG was isolated in 153 adult patients, who had a mean age of 67 years, most of them being women (80 %). Most of our patients (65 %) had some underlying disease, with urologic disease being the most common (37 %), followed by diabetes mellitus (27 %) and neurologic disease (25 %). Among the 88 patients in whom we were able to correctly assess symptoms, 45 % had asymptomatic bacteriuria, 35 % had lower urinary tract infection, and 20 % had upper urinary tract infection. In 14 cases (9 %), SBG was also isolated in blood cultures. Most of the isolates of SBG (72 %) were S. gallolyticus subsp. pasteurianus. All isolates were susceptible to penicillin, 98 % to nitrofurantoin, and 77 % to fosfomycin. Although SBG bacteriuria is uncommon, it should not always be taken as a contaminant, mainly when S. pasteurianus is isolated, because it may cause urinary tract infections and, occasionally, sepsis, whereas when S. gallolyticus is isolated from urine, it may be a marker of underlying endocarditis and colorectal cancer.

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References

  1. Tripodi MF, Adinolfi LE, Ragone E et al (2004) Streptococcus bovis endocarditis and its association with chronic liver disease: an underestimated risk factor. Clin Infect Dis 38:1394–400

    Article  CAS  PubMed  Google Scholar 

  2. Corredoira J, Alonso MP, García-Garrote F et al (2014) Streptococcus bovis group and biliary tract infections: an analysis of 51 cases. Clin Microbiol Infect 20:405–409. doi:10.1111/1469-0691.12333

    Article  CAS  PubMed  Google Scholar 

  3. Corredoira J, Alonso MP, Coira A, Varela J (2008) Association between Streptococcus infantarius (formerly S. bovis II/1) bacteremia and noncolonic cancer. J Clin Microbiol 46:1570

    Article  PubMed Central  PubMed  Google Scholar 

  4. Lazarovitch T, Shango M, Levine M et al (2013) The relationship between the new taxonomy of Streptococcus bovis and its clonality to colon cancer, endocarditis, and biliary disease. Infection 41:329–337

    Article  CAS  PubMed  Google Scholar 

  5. Klatte JM, Clarridge JE 3rd, Bratcher D, Selvarangan R (2012) A longitudinal case series description of meningitis due to Streptococcus gallolyticus subsp. pasteurianus in infants. J Clin Microbiol 50:57–60

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  6. Thatrimontrichai A, Chanvitan P, Janjindamai W, Dissaneevate S, Maneenil G (2012) Early onset neonatal bacterial meningitis caused by Streptococcus gallolyticus subsp. pasteurianus. Southeast Asian J Trop Med Public Health 43:145–151

    PubMed  Google Scholar 

  7. Clarridge JE 3rd, Attorri SM, Zhang Q, Bartell J (2001) 16S ribosomal DNA sequence analysis distinguishes biotypes of Streptococcus bovis: Streptococcus bovis biotype II/2 is a separate genospecies and the predominant clinical isolate in adult males. J Clin Microbiol 39:1549–1552

    Article  PubMed Central  PubMed  Google Scholar 

  8. Uh Y, Kwon O, Yoon K, Hwang GY, Kim HY (2006) Underlying diseases associated with Streptococcus bovis bacteremia and antimicrobial susceptibility of the organism. Korean J Clin Microbiol 9:36–41

    Google Scholar 

  9. Fernández-Ruiz M, Villar-Silva J, Llenas-García J et al (2010) Streptococcus bovis bacteraemia revisited: clinical and microbiological correlates in a contemporary series of 59 patients. J Infect 61:307–313

    Article  PubMed  Google Scholar 

  10. Romero B, Morosini MI, Loza E et al (2011) Reidentification of Streptococcus bovis isolates causing bacteremia according to the new taxonomy criteria: still an issue? J Clin Microbiol 49:3228–3233

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  11. Gómez-Garcés JL, Gil Y, Burillo A, Wilhelmi I, Palomo M (2012) Diseases associated with bloodstream infections caused by the new species included in the old Streptococcus bovis group. Enferm Infecc Microbiol Clin 30:175–179

    Article  PubMed  Google Scholar 

  12. Siegman-Igra Y, Schwartz D (2003) Streptococcus bovis revisited: a clinical review of 81 bacteremic episodes paying special attention to emerging antibiotic resistance. Scand J Infect Dis 35:90–93

    Article  CAS  PubMed  Google Scholar 

  13. Poulsen LL, Bisgaard M, Thai Son N, Vu Trung N, Manh An H, Dalsgaard A (2012) Enterococcus and Streptococcus spp. associated with chronic and self-medicated urinary tract infections in Vietnam. BMC Infect Dis 12:320

    Article  PubMed Central  PubMed  Google Scholar 

  14. Murray PR, Baron EJ, Jorgensen JH, Landry ML, Pfaller MA (eds) (2007) Manual of clinical microbiology, 9th edn. ASM Press, Washington, DC

    Google Scholar 

  15. Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40:373–383

    Article  CAS  PubMed  Google Scholar 

  16. Hoppes WL, Lerner PI (1974) Nonenterococcal group-D streptococcal endocarditis caused by Streptococcus bovis. Ann Intern Med 81:588–593

    Article  CAS  PubMed  Google Scholar 

  17. Andreu A, Alós JI, Gobernado M, Marco F, de la Rosa M, García-Rodríguez JA; Grupo Cooperativo Español para el Estudio de la Sensibilidad Antimicrobiana de los Patógenos Urinarios (2005) Etiology and antimicrobial susceptibility among uropathogens causing community-acquired lower urinary tract infections: a nationwide surveillance study. Enferm Infecc Microbiol Clin 23:4–9

    Article  PubMed  Google Scholar 

  18. Murray HW, Roberts RB (1978) Streptococcus bovis bacteremia and underlying gastrointestinal disease. Arch Intern Med 138:1097–1099

    Article  CAS  PubMed  Google Scholar 

  19. Siegel JD, McCracken GH Jr (1978) Group D streptococcal infections. J Pediatr 93:542–543

    Article  CAS  PubMed  Google Scholar 

  20. Collins LE, Clarke RW, Maskell R (1986) Streptococci as urinary pathogens. Lancet 2:479–481

    Article  CAS  PubMed  Google Scholar 

  21. Corredoira J, Alonso MP, Coira A et al (2008) Characteristics of Streptococcus bovis endocarditis and its differences with Streptococcus viridans endocarditis. Eur J Clin Microbiol Infect Dis 27:285–291

    Article  CAS  PubMed  Google Scholar 

  22. Kass EH (1956) Asymptomatic infections of the urinary tract. Trans Assoc Am Physicians 69:56–64

    CAS  PubMed  Google Scholar 

  23. Muñoz P, Coque T, Rodríguez Créixems M, Bernaldo de Quirós JC, Moreno S, Bouza E (1992) Group B Streptococcus: a cause of urinary tract infection in nonpregnant adults. Clin Infect Dis 14:492–496

    Article  PubMed  Google Scholar 

  24. Persson KM, Grabe M, Kristiansen P, Forsgren A (1988) Significance of group B streptococci in urine cultures from males and non-pregnant females. Scand J Infect Dis 20:47–53

    Article  CAS  PubMed  Google Scholar 

  25. Hooton TM, Roberts PL, Cox ME, Stapleton AE (2013) Voided midstream urine culture and acute cystitis in premenopausal women. N Engl J Med 369:1883–1891

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  26. Gross PA, Flower M, Barden G (1976) Polymicrobic bacteriuria: significant association with bacteremia. J Clin Microbiol 3:246–250

    PubMed Central  CAS  PubMed  Google Scholar 

  27. Stamm WE, Counts GW, Running KR, Fihn S, Turck M, Holmes KK (1982) Diagnosis of coliform infection in acutely dysuric women. N Engl J Med 307:463–468

    Article  CAS  PubMed  Google Scholar 

  28. Staplenton AE (2014) Urinary tract infection pathogenesis: host factors. Infect Dis Clin North Am 28:149–159

    Article  PubMed  Google Scholar 

  29. Chirouze C, Patry I, Duval X et al (2013) Streptococcus bovis/Streptococcus equinus complex fecal carriage, colorectal carcinoma, and infective endocarditis: a new appraisal of a complex connection. Eur J Clin Microbiol Infect Dis 32:1171–1176

    Article  CAS  PubMed  Google Scholar 

  30. Lurie S, Asaala H, Harari OS, Golan A, Sadan O (2010) Uterine cervical non-gonococcal and non-chlamydial bacterial flora and its antibiotic sensitivity in women with pelvic inflammatory disease: did it vary over 20 years? Isr Med Assoc J 12:747–750

    PubMed  Google Scholar 

  31. Steux R, Dubois D, Bonnet R, Jacquetin B, Hennequin C (2008) Streptococcus anginosus and Streptococcus gallolyticus subsp. pasteurianus chorioamniotitis. Med Mal Infect 38:507–509

    Article  CAS  PubMed  Google Scholar 

  32. Diehl R, Cottin X, Pérouse de Montclos M, Claris O (2010) Neonatal bacteremia due to Streptococcus gallolyticus subsp. pasteurianus. Arch Pediatr 17:1594–1595

    Article  CAS  PubMed  Google Scholar 

  33. Binghuai L, Wenjun S, Xinxin L (2013) Intrauterine infection and post-partum bacteraemia due to Streptococcus gallolyticus subsp. pasteurianus. J Med Microbiol 62:1617–1619

    Article  PubMed  Google Scholar 

  34. Punpanich W, Munsrichoom A, Dejsirilert S (2012) Streptococcus gallolyticus subspecies pasteurianus meningitis in an infant: a case report and literature review. J Med Assoc Thai 95:1606–1612

    PubMed  Google Scholar 

  35. Fikar CR, Levy J (1979) Streptococcus bovis meningitis in a neonate. Am J Dis Child 133:1149–1150

    CAS  PubMed  Google Scholar 

  36. Gavin PJ, Thomson RB Jr, Horng SJ, Yogev R (2003) Neonatal sepsis caused by Streptococcus bovis variant (biotype II/2): report of a case and review. J Clin Microbiol 41:3433–3435

    Article  PubMed Central  PubMed  Google Scholar 

  37. Beck M, Frodl R, Funke G (2008) Comprehensive study of strains previously designated Streptococcus bovis consecutively isolated from human blood cultures and emended description of Streptococcus gallolyticus and Streptococcus infantarius subsp. coli. J Clin Microbiol 46:2966–2972

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  38. Corredoira-Sánchez J, García-Garrote F, Coira A, López-Agreda H, Alonso-García MP (2014) Colorectal neoplasia associated with Streptococcus gallolyticus subspecies pasteurianus. Lancet Infect Dis 14:272–273

    Article  Google Scholar 

  39. Lin IH, Liu TT, Teng YT et al (2011) Sequencing and comparative genome analysis of two pathogenic Streptococcus gallolyticus subspecies: genome plasticity, adaptation and virulence. PLoS One 6(5): e20519. doi:10.1371/journal.pone.0020519

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  40. Asgeirsson H, Kristjansson M, Kristinsson KG, Gudlaugsson O (2012) Clinical significance of Staphylococcus aureus bacteriuria in a nationwide study of adults with S. aureus bacteraemia. J Infect 64:41–46

    Article  PubMed  Google Scholar 

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Acknowledgments

Thanks go to Dr. A. Andreu for the kind review of this manuscript.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Internal Medicine, Hospital Lucus Augusti, Lugo, Spain

    M. Matesanz, D. Rubal & I. Iñiguez

  2. Infectious Disease Unit, Hospital Lucus Augusti, San Cibrao s/n, 27003, Lugo, Spain

    R. Rabuñal, M. J. García-País, M. J. López-Álvarez & J. Corredoira

  3. Department of Clinical Microbiology, Hospital Lucus Augusti, Lugo, Spain

    F. García-Garrote, A. Coira, J. Pita, A. Rodriguez-Macias & M. P. Alonso

Authors
  1. M. Matesanz
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  2. D. Rubal
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  3. I. Iñiguez
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  4. R. Rabuñal
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  5. F. García-Garrote
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  6. A. Coira
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  7. M. J. García-País
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  9. A. Rodriguez-Macias
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  11. M. P. Alonso
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  12. J. Corredoira
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Correspondence to J. Corredoira.

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Matesanz, M., Rubal, D., Iñiguez, I. et al. Is Streptococcus bovis a urinary pathogen?. Eur J Clin Microbiol Infect Dis 34, 719–725 (2015). https://doi.org/10.1007/s10096-014-2273-x

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  • DOI: https://doi.org/10.1007/s10096-014-2273-x

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