Bacteremia with the bovis group streptococci: species identification and association with infective endocarditis and with gastrointestinal disease.
DNA sequencing of the intergenic spacer (ITS) region was used to identify 53 blood culture isolates that had previously been designated to the bovis group streptococci and clinical data was collected retrospectively from patients' records using a standardized protocol. ITS sequencing identified 19 (35.8%) isolates as Streptococcus gallolyticus subsp. gallolyticus, 12 (22.6%) as S. gallolyticus subsp. pasteurianus, two (3.8%) as S. gallolyticus subsp. macedonicus, seven (13.2%) as S. infantarius subsp. infantarius, 12 (22.6%) as S. lutetiensis and one (1.9%) as S. equinus. The association of S. gallolyticus subsp. gallolyticus with colorectal neoplasia and with infective endocarditis and the association between S. gallolyticus subsp. pasteurianus and pancreatic cancer were found to be clinically important. Also, a very high 1-year mortality rate with S. lutetiensis (66.7%) and S. gallolyticus subsp. pasteurianus (58.7%) bacteremia calls for intensive investigation for underlying disease focusing on the pancreas and the hepatobiliary system.
Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark. Electronic address: ea.sofie.marmolin2@rsyd.dk.
Ea S
ES
Marmolin
Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark; Department of Clinical Microbiology, Slagelse Hospital, Slagelse, Denmark.
Gitte N
GN
Hartmeyer
Department of Clinical Microbiology, Slagelse Hospital, Slagelse, Denmark.
Jens J
JJ
Christensen
Department of Clinical Microbiology, Slagelse Hospital, Slagelse, Denmark.
Xiaohui C
XC
Nielsen
Department of Clinical Microbiology, Slagelse Hospital, Slagelse, Denmark.
Rimtas
R
Dargis
Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark.
Marianne N
MN
Skov
Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark.
Elisa
E
Knudsen
Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark.
Michael
M
Kemp
Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark.
Ulrik S
US
Justesen
D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000382:microbiology*; D016000:Cluster Analysis; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D021903:DNA, Ribosomal Spacer / Q000737:chemistry / Q000235:genetics; D004696:Endocarditis / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010802:Phylogeny; D012189:Retrospective Studies; D017422:Sequence Analysis, DNA; D013290:Streptococcal Infections / Q000382:microbiology*; D013291:Streptococcus / Q000145:classification* / Q000302:isolation & purification*; D016985:Streptococcus bovis
D004269:DNA, Bacterial; D021903:DNA, Ribosomal Spacer
Bacteremia; Bovis group streptococci; Colorectal cancer; Infective endocarditis; Sequencing of the intergenic spacer region