Streptococcus bovis revisited: a clinical review of 81 bacteremic episodes paying special attention to emerging antibiotic resistance.
Following 2 Cases of Streprococcus bovis endocarditis with a high level of resistance to clindamycin during 2002, the authors reviewed their clinical experience with S. bovis bacteremia during 2 periods, starting in 1980. 81 episodes of S. bovis bacteremia represented approximately 1% of all episodes of bacteremia. In 32 (40%) cases the bacteremia represented endocarditis, in 15 (19%) the bacteremia originated from sick bowel, 11 (14%) were suspected to arise from urinary tract infection, 10 (12%) originated from biliary or peritoneal infection, and 13 from other or unknown sources. 25 (31%) of the bacteremias were polymicrobial. All of the isolates were highly susceptible to penicillin and clindamycin, with the following exceptions: 2 isolates had a minimal inhibitory concentration (MIC) of 0.5 mg/l to penicillin (in 1997) and 5 isolates had an MIC of > 2 mg/l to clindamycin (in 1997, 1998, 2000 and 2002). The 2 most recent of these 5 had high-level resistance to clindamycin of > 256 mg/l. It seems that clindamycin resistance in S. bovis is an emerging phenomenon, in contrast to penicillin resistance, high levels of which have not yet been described in S. bovis.
Siegman-Igra
Yardena
Y
Infectious Diseases Unit, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. ZIHUM@tasmc.health.gov.il
Schwartz
David
D
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D016470:Bacteremia / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D024881:Drug Resistance, Bacterial; D005260:Female; D005500:Follow-Up Studies; D006784:Hospitals, Teaching; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013290:Streptococcal Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D016985:Streptococcus bovis / Q000187:drug effects* / Q000302:isolation & purification; D015996:Survival Rate
D000900:Anti-Bacterial Agents