title: Hospital-based study of viridans streptococcal bacteraemia in children and adults.
abstract: OBJECTIVE
  To assess the proportion and clinical significance of bacteraemia caused by viridans streptococci (VS) in immunocompetent adults and children.
  
  
  METHODS
  Over a 25-month period, we collected data on all patients with VS bacteraemia at a UK district general hospital.
  
  
  RESULTS
  VS caused 50/723 (6.9%) adult and 13/106 (12.3%) paediatric community-acquired bacteraemias. Of the 43 adult and 12 paediatric patient notes reviewed, 26 (47.3%) cultures were of 'definite' or 'probable' clinical significance. No patients were neutropenic and overall penicillin resistance was 11/55 (20.0%). Amongst adults, there were five (11.6%) confirmed or suspected cases of infective endocarditis compared to none in the paediatric cohort. Similar proportions of adults (16.3%) and children (16.7%) had lower respiratory tract infections. Among non-significant cultures, a history of seizures was observed in one (1.3%) adult and four (33.3%) children (p=0.008). Thirty-day mortality was 7.3%. No children and four adults died, one directly attributable to infection. Median adult inpatient stay was 11 days compared to 2 days in the paediatric population (p=0.003).
  
  
  CONCLUSIONS
  Despite cases of infective endocarditis and an incidence of penicillin resistance of 20%, mortality directly attributable to VS infection in immunocompetent adults and children was rare.
authors: Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK. lionel.tan@nhs.net
authors: Lionel K K
authors: LK
authors: Tan
authors: Sandra
authors: S
authors: Lacey
authors: Sundhiya
authors: S
authors: Mandalia
authors: Mark
authors: M
authors: Melzer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology / Q000503:physiopathology; D005260:Female; D006760:Hospitalization; D006769:Hospitals, General; D006801:Humans; D007121:Immunocompetence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D013290:Streptococcal Infections / Q000453:epidemiology / Q000382:microbiology / Q000503:physiopathology; D006113:United Kingdom / Q000453:epidemiology; D034363:Viridans Streptococci / Q000145:classification / Q000302:isolation & purification