title: Association between bacteremia due to Streptococcus gallolyticus subsp. gallolyticus (Streptococcus bovis I) and colorectal neoplasia: a case-control study.
abstract: BACKGROUND
  The association between bacteremia by Streptococcus gallolyticus subsp. gallolyticus (SGG) and colorectal neoplasia (CRN) is well established but the frequency of the association varies widely in different studies. We conducted a case-control study to assess the association between SGG bacteremia and CRN.
  
  
  METHODS
  An analysis of all SGG bacteremias was performed during the period 1988-2011. The frequency of CRN in patients with SGG bacteremia was compared with the frequency of CRN in a symptomatic control group of patients matched at a 1:2 ratio for gender and age (±3 years) without S. bovis bacteremia and personal history of CRN and with increased risk of CRN (by the presence of symptoms, signs, or test suspicious of colonic pathology or by family history of CRN).
  
  
  RESULTS
  One hundred nine cases of SGG bacteremia were detected (mean age, 66 years; 87% male). Colonoscopy was performed in 98 cases, diagnosing 69 cases of CRN: 57 adenomas (39 advanced adenomas) and 12 invasive carcinomas. Only 4 cases had suspected CRN before the blood culture. The prevalence of CRN was higher in patients with SGG bacteremia than in the 196 control patients (70% vs 32%; odds ratio [OR], 5.1; 95% confidence interval [CI], 3.0-8.6). This difference was not significant when comparing nonadvanced adenomas (19% vs 12%), but we found significant differences in advanced adenomas (40% vs 16%; OR, 3.5; 95% CI, 2.0-6.1) and invasive carcinomas (12% vs 5%; OR, 2.9; 95% CI, 1.2-6.9).
  
  
  CONCLUSIONS
  The frequency of CRN among SGG infected patients is significantly increased compared with symptomatic age-matched controls, indicating that SGG infection is a strong indicator for underlying occult malignancy.
authors.affiliation: Infectious Disease Unit, Hospital Universitario Lucus Augusti, Lugo, Spain. isabelcoira@mundo-r.com
authors.forename: Juan
authors.initials: J
authors.lastname: Corredoira-Sánchez
authors.forename: Fernando
authors.initials: F
authors.lastname: García-Garrote
authors.forename: Ramón
authors.initials: R
authors.lastname: Rabuñal
authors.forename: Leopoldo
authors.initials: L
authors.lastname: López-Roses
authors.forename: M Jose
authors.initials: MJ
authors.lastname: García-País
authors.forename: Elena
authors.initials: E
authors.lastname: Castro
authors.forename: Roberto
authors.initials: R
authors.lastname: González-Soler
authors.forename: Amparo
authors.initials: A
authors.lastname: Coira
authors.forename: Julia
authors.initials: J
authors.lastname: Pita
authors.forename: M Jose
authors.initials: MJ
authors.lastname: López-Álvarez
authors.forename: M Pilar
authors.initials: MP
authors.lastname: Alonso
authors.forename: Jose
authors.initials: J
authors.lastname: Varela
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000382:microbiology / Q000473:pathology*; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013290:Streptococcal Infections / Q000382:microbiology* / Q000473:pathology*; D016985:Streptococcus bovis / Q000302:isolation & purification*