title: Streptococcus mitis strains causing severe clinical disease in cancer patients.
abstract: The genetically diverse viridans group streptococci (VGS) are increasingly recognized as the cause of a variety of human diseases. We used a recently developed multilocus sequence analysis scheme to define the species of 118 unique VGS strains causing bacteremia in patients with cancer; Streptococcus mitis (68 patients) and S. oralis (22 patients) were the most frequently identified strains. Compared with patients infected with non-S. mitis strains, patients infected with S. mitis strains were more likely to have moderate or severe clinical disease (e.g., VGS shock syndrome). Combined with the sequence data, whole-genome analyses showed that S. mitis strains may more precisely be considered as >2 species. Furthermore, we found that multiple S. mitis strains induced disease in neutropenic mice in a dose-dependent fashion. Our data define the prominent clinical effect of the group of organisms currently classified as S. mitis and lay the groundwork for increased understanding of this understudied pathogen.
authors.forename: Samuel A
authors.initials: SA
authors.lastname: Shelburne
authors.forename: Pranoti
authors.initials: P
authors.lastname: Sahasrabhojane
authors.forename: Miguel
authors.initials: M
authors.lastname: Saldana
authors.forename: Hui
authors.initials: H
authors.lastname: Yao
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Su
authors.forename: Nicola
authors.initials: N
authors.lastname: Horstmann
authors.forename: Erika
authors.initials: E
authors.lastname: Thompson
authors.forename: Anthony R
authors.initials: AR
authors.lastname: Flores
mesh_terms: D000818:Animals; D016470:Bacteremia / Q000150:complications / Q000382:microbiology; D015331:Cohort Studies; D004195:Disease Models, Animal; D005260:Female; D005798:Genes, Bacterial; D020043:Genes, Essential; D016680:Genome, Bacterial; D006801:Humans; D051379:Mice; D058885:Multilocus Sequence Typing; D009369:Neoplasms / Q000150:complications*; D010802:Phylogeny; D012720:Severity of Illness Index; D013290:Streptococcal Infections / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology; D034361:Streptococcus mitis / Q000145:classification / Q000235:genetics* / Q000472:pathogenicity; D014774:Virulence
keywords: Pitt bacteremia score; Streptococcus mitis; bacteremia; bacteria; cancer; cancer patients; characterization; multilocus sequence analysis; neutropenia; viridans group streptococci
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