title: [Streptococcus gallolyticus (ex S. bovis) bacteremia and its relationship with colonic or hepatobiliary disease and endocarditis].
abstract: BACKGROUND
  Bacteremia due to Streptococcus bovis (now S. gallolyticus) has been traditionally associated to colon or hepatobiliar disease and endocarditis but there is no information on this matter in Chile.
  
  
  OBJECTIVE
  To describe clinical features of adult patients suffering bacteremia by S. bovis/S. gallolyticus, identify the source of the bacteremia and the frequency of endocarditis.
  
  
  METHODS
  Retrospective-descriptive study using laboratory records.
  
  
  RESULTS
  Between January 2003 and August 2014, 23 S. bovis/S. gallolyticus bacteremic events were identified among 22 patients. Mean age was 72.7 years (range 46-96). Co-morbidities were frequent (9.1 to 47.6%). The primary source of bacteremia was intestinal in 52.2%; hepatobiliar in 17.4% and in 34.8% it was not elucidated. Six patients had infective endocarditis (26.1%) and one patient had espondylodiscitis (4.3%). S. bovis represented 39.1% of isolates (all until 2008), S. gallolyticus subsp pasteurianus 39.1% and, S. gallolyticus subsp infantarius and S. gallolyticus subsp gallolyticus 8.7% each one, respectively. Association studies between the bacteremic source or endocarditis with specific S. gallolyticus subspecies were limited by the small number of isolates. Seven patients (30.4%) underwent surgical interventions. In-hospital mortality reached 21.7% (n=5).
  
  
  CONCLUSIONS
  Although infrequent, bacteremic events by S. gallolyticus/S. bovis have increased in-hospital mortality, require surgical intervention and affect older patients with co-morbidities. Near two-thirds suffer from colonic or hepatobiliary disease that act as the primary source of bacteremia. In addition, near one fourth is affected by infective endocarditis. Detection of S. gallolyticus/S. bovis in blood cultures prompts a thorough clinical evaluation in order to clarify the source of the bloodstream infection and the presence of complications.
authors.forename: Cristina
authors.initials: C
authors.lastname: Amado
authors.forename: M José
authors.initials: MJ
authors.lastname: Hidalgo
authors.forename: Cecilia
authors.initials: C
authors.lastname: Sedano
authors.forename: Allan
authors.initials: A
authors.lastname: Hebel
authors.forename: Lorena
authors.initials: L
authors.lastname: Porte
authors.forename: Stephanie
authors.initials: S
authors.lastname: Braun
authors.forename: Jeannette
authors.initials: J
authors.lastname: Dabanch
authors.forename: Alberto
authors.initials: A
authors.lastname: Fica
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000382:microbiology*; D001660:Biliary Tract Diseases / Q000382:microbiology; D002761:Cholangitis / Q000382:microbiology*; D003108:Colonic Diseases / Q000382:microbiology*; D015299:Discitis / Q000382:microbiology; D004696:Endocarditis / Q000382:microbiology*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008100:Liver Abscess / Q000382:microbiology*; D008107:Liver Diseases / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013290:Streptococcal Infections / Q000382:microbiology* / Q000401:mortality; D016985:Streptococcus bovis / Q000145:classification* / Q000472:pathogenicity